Provider Demographics
NPI:1841371291
Name:BINKS, SIDNEY WALTER III (PHD)
Entity type:Individual
Prefix:DR
First Name:SIDNEY
Middle Name:WALTER
Last Name:BINKS
Suffix:III
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3000 CONNECTICUT AVE NW
Mailing Address - Street 2:STE 238
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20008-2531
Mailing Address - Country:US
Mailing Address - Phone:202-255-5187
Mailing Address - Fax:202-234-6373
Practice Address - Street 1:3000 CONNECTICUT AVE NW
Practice Address - Street 2:STE 238
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20008-2531
Practice Address - Country:US
Practice Address - Phone:202-255-5187
Practice Address - Fax:202-234-6373
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-18
Last Update Date:2018-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD03064103G00000X, 103T00000X, 103TC0700X, 103TF0200X, 103TH0100X, 103TM1800X, 103TP2701X
DCPSY1773103T00000X, 103TC0700X, 103TF0200X, 103TH0100X, 103TM1800X, 103TP2701X, 103TR0400X, 103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensic
No103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth Service
No103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental Disabilities
No103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup Psychotherapy
No103TR0400XBehavioral Health & Social Service ProvidersPsychologistRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD03064OtherMARYLAND LICENSE #
DCPSY1773OtherSTATE LICENSE NUMBER
DC832414Medicare ID - Type UnspecifiedMEDICARE #
DCPSY1773OtherSTATE LICENSE NUMBER