Provider Demographics
NPI:1881158046
Name:DR. BENSFIELD, PSYD
Entity type:Organization
Organization Name:DR. BENSFIELD, PSYD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINICAL THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:BENSFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:708-906-5478
Mailing Address - Street 1:2428 BURR OAK AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH RIVERSIDE
Mailing Address - State:IL
Mailing Address - Zip Code:60546-1513
Mailing Address - Country:US
Mailing Address - Phone:708-906-5478
Mailing Address - Fax:
Practice Address - Street 1:2428 BURR OAK AVE
Practice Address - Street 2:
Practice Address - City:NORTH RIVERSIDE
Practice Address - State:IL
Practice Address - Zip Code:60546-1513
Practice Address - Country:US
Practice Address - Phone:708-906-5478
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-22
Last Update Date:2019-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)