Organization
THE CENTER FOR DYNAMIC PRACTICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BENJAMIN GREENBERG PSYD (DIRECTOR)
(505) 636-6550
Entity
Organization
Contact information
Practice address
1221 S SAINT FRANCIS DR STE B, SANTA FE, NM 87505-4036
(505) 636-6550
(505) 372-6979
Mailing address
1221 S SAINT FRANCIS DR STE B, SANTA FE, NM 87505-4036
(505) 636-6550
Taxonomy
Speciality
Code
Description
License number
State
102L00000X
Psychoanalyst
—
—
103TA0700X
Adult Development & Aging Psychologist
—
—
103TC0700X
Clinical Psychologist
—
—
103TH0100X
Health Service Psychologist
Primary
—
—
103TP0814X
Psychoanalysis Psychologist
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/13/2022
Last updated
04/13/2022
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