Willis, Benny S

Willis, Benny S is an sole proprietor health care provider with primary practice located at 691 Massachussets Avenue Suite 10, Arlington MA 02479-1648. He recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Cognitive & Behavioral, Behavioral Health & Social Service Providers / Psychologist, Behavioral Health & Social Service Providers / Clinical Child & Adolescent. Behavioral Health & Social Service Providers / Clinical Child & Adolescent is his primary health care specialty. Willis, Benny S can be contacted via phone (617) 242-4228.

Contact Information

Primary practice address
691 Massachussets Avenue Suite 10 Arlington MA 02479-1648
Phone: (617) 242-4228
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Cognitive & Behavioral 103TB0200X 6244 Massachusetts
Behavioral Health & Social Service Providers / Psychologist 103T00000X 6244 Massachusetts
Behavioral Health & Social Service Providers / Clinical Child & Adolescent 103TC2200X 6244 Massachusetts

Profile Details

NPI number 1407905995
LBN Legal business name Willis, Benny S
Credentials PH.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 10th, 2007
Last updated Nov 25th, 2015 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1407905995 NPPES
Massachusetts Other WO4947 BLUE CROSS BLUE SHIELD

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