Provider Demographics
NPI:1992851109
Name:BENSON, ANNE B (PSYD)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:B
Last Name:BENSON
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:635 MAIN ST
Mailing Address - Street 2:STE 1A
Mailing Address - City:GREAT BARRINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:01230-2002
Mailing Address - Country:US
Mailing Address - Phone:413-528-9504
Mailing Address - Fax:413-528-9522
Practice Address - Street 1:500 MAIN ST
Practice Address - Street 2:SUITE 6
Practice Address - City:GREAT BARRINGTON
Practice Address - State:MA
Practice Address - Zip Code:01230-2003
Practice Address - Country:US
Practice Address - Phone:413-528-9504
Practice Address - Fax:413-528-9522
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-28
Last Update Date:2016-07-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA7941103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent