Provider Demographics
NPI:1972102911
Name:BENJAMIN, PHILIP H (LMHCA)
Entity type:Individual
Prefix:
First Name:PHILIP
Middle Name:H
Last Name:BENJAMIN
Suffix:
Gender:M
Credentials:LMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:716 BOYLSTON AVE E UNIT 8
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98102-4999
Mailing Address - Country:US
Mailing Address - Phone:206-605-0862
Mailing Address - Fax:
Practice Address - Street 1:PHILIP BENJAMIN SEATTLE PSYCHOLOGY, PLLC 200 W. MERCER
Practice Address - Street 2:SUITE 111
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98119
Practice Address - Country:US
Practice Address - Phone:206-605-0862
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-21
Last Update Date:2020-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61102905101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health