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General NPI Number Information
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NPI Number | 1164208237
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Entity Type | Individual
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Provider Name | BENJAMIN BILLINGSLEY PHD
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Gender | Male
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Dates
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Enumeration Date | 09/05/2023
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Last Update Date | 02/07/2025
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Provider Practice Location Address
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Address Line | 10 MUZZEY ST STE 9
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City | LEXINGTON
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State | MA
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Zip | 02421-5200
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Country | US
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Telephone | 914-462-8338
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Fax |
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Provider Business Mailing Address
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Address Line | 747 MAIN ST STE 324
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City | CONCORD
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State | MA
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Zip | 01742-3329
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY10000721
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License Number State | MA
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