| Doctor Name: | DR. BENJAMIN TYLER WOOD |
| NPI Number: | 1669859120 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PH.D. |
| License Number: | 10107 |
| Business Practice Address: | 17 Housatonic St Lenox, MA - 012402519 |
| Business Phone Number: | 2055359295 |
| Business Fax Number: | |
| Mailing Address: | 17 Housatonic St, LENOX |
| State: | MA |
| Postal Code: | 012402519 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 05/04/2015 |
| NPI Last Update Date: | 05/04/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TH0100X |
| License Number: | 10107 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Health Service |
| Taxonomy Definition: | A psychologist, certified/licensed at the independent practice level in his/her state, who is duly trained and experienced in the delivery of direct, preventative, assessment, and therapeutic intervention services to individuals whose growth, adjustment, or functioning is actually impaired or is demonstrably at high risk of impairment (1974). |