MARISSA L BENNERS (NPI# 1265048417) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265048417 |
| Entity Type | Individual |
| Full Name | MARISSA L BENNERS |
| Credential | PHD |
| Practice Address |
3304 Colorado Blvd Ste 102 Denton TX 76210-6872 |
| Mailing Address |
Po Box 99213 Fort Worth TX 76199-0213 |
| Practice Telephone | 9404844311 |
| Practice Fax Number | 9404845075 |
| Mailing Telephone | 6828851860 |
| Mailing Fax Number | 6828851396 |
| Enumeration Date | 2020-09-22 |
| Last Update Date | 2020-09-22 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC2200X |
Psychologist Specialization: Clinical Child & Adolescent |
38197 | TX | Behavioral Health & Social Service Providers |
| Street Address |
3304 COLORADO BLVD STE 102 |
| City | DENTON |
| State | TX |
| Zip Code | 76210-6872 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609403716 | Corinth Community Pharmacy, LLC. | Pharmacy | 3001 F.m. 2181, Suite 450, Corinth, TX 76210 | 2020-03-26 |
| 1003467200 | Stephanie R Rynor I | Nurse Practitioner | 3001 Fm 2181 Ste 300, Corinth, TX 76210 | 2019-09-28 |
| 1417435389 | Ikids Pediatric Dentistry Denton, Pllc | Dentist | 1212 Bent Oaks Ct Ste 100, Denton, TX 76210 | 2018-08-02 |
| 1083100101 | Ahir Dental Pllc | Dentist | 3220 Teasley Ln, Suite#100, Dention, TX 76210 | 2018-07-02 |
| 1235636010 | Diane Michelle Dean | Counselor | 2701 Shoreline Drive, Denton, TX 76210 | 2018-04-09 |
| 1740709344 | Southridge Dental, LLC | Dentist | 3303 Unicorn Lake Blvd, Ste 200, Denton, TX 76210 | 2017-09-14 |
| 1356876601 | Cvs Pharmacy Inc | Durable Medical Equipment & Medical Supplies | 1101 Fm 2181, Corinth, TX 76210 | 2017-04-25 |
| 1366990137 | Phee Dental Group | Dentist | 4920 Teasley Ln, Denton, TX 76210 | 2016-09-21 |
| 1265893283 | Ann Marie Norris | Respiratory Therapist, Registered | 3535 E I-35, Denton, TX 76210 | 2016-03-18 |
| 1447644778 | Santa Patricia Espinoza | Nurse Practitioner | 3537 South Interstate 35e, Ste. 210, Denton, TX 76210 | 2015-03-25 |
| Find all providers in zip 76210 | ||||
| Taxonomy Code | 103TC2200X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical Child & Adolescent |
| Definition to come... |
| Notes: [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235741778 | Capital Area Psychological & Evaluation Services, Pllc | Psychologist | 1715 W Fm 1626 Ste 200, Manchaca, TX 78652-3549 | 2020-08-17 |
| 1396354718 | Tarrah Mitchell | Psychologist | 3918 125th St, Lubbock, TX 79423-8906 | 2020-07-31 |
| 1861010126 | Ankita Krishnan | Psychologist | 1601 Trinity St Bldg B, Austin, TX 78712-1765 | 2020-07-13 |
| 1386285567 | Nicole Anderson | Psychologist | 17100 Glenmount Park Dr Ste C, Webster, TX 77598-4368 | 2019-09-30 |
| 1982253555 | Sarah A Koenig | Psychologist | 8500 Shoal Creek Blvd Bldg 4, Austin, TX 78757-7591 | 2019-09-06 |
| 1790341261 | Ann Caballero | Psychologist | 20333 St Hwy 249 Ste 200, Houston, TX 77070-2613 | 2019-05-10 |
| 1396231064 | Crystal Gayle | Psychologist | 3626 N Hall St Ste 550, Dallas, TX 75219-5105 | 2018-07-06 |
| 1104314533 | Kelly Nicole Banneyer | Psychologist | 6701 Fannin St Ste 1630, Houston, TX 77030-2615 | 2018-05-01 |
| 1679086615 | Houston Psychology and Wellness, Pllc | Psychologist | 1111 North Loop W Ste 820, Houston, TX 77008-4715 | 2017-11-13 |
| 1053820068 | Mark Anthon Lott | Psychologist | 2222 Medical District Dr Ste 105, Dallas, TX 75235-8075 | 2017-09-21 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.