Individual provider Active NPI

Rebecca Bengtson, MA, LMFT

  • Marriage & Family Therapist
  • Elk River, MN
National Provider Identifier
1073967824
Registry record updated Feb 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
3244 Issued in MN
Practice address
657 Main St NW
Elk River, MN 55330-1584
Phone
(651) 253-7262
NPI assigned
Apr 18, 2016
Last updated
Feb 1, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 3244 MN Primary

Addresses

Primary practice location

657 Main St NW
Elk River, MN 55330-1584

Mailing address

19884 Polk St NW
Elk River, MN 55330-2276

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jul 15, 2025 through Jul 15, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
3244MNMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Embrace Mental Wellness Marriage & Family Therapist CurrentSince Feb 8, 2023 Accepting new patients

Locations

657 Main St NW
Elk River, MN 55330
Phone (651) 253-7262

657 Main St NW
Ste 207
Elk River, MN 55330
Phone (651) 253-7262

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1460937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675209600000",
    "number": "1073967824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19884 POLK ST NW",
            "city": "ELK RIVER",
            "state": "MN",
            "postal_code": "553302276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "657 MAIN ST NW",
            "city": "ELK RIVER",
            "state": "MN",
            "postal_code": "553301584",
            "telephone_number": "651-253-7262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENGTSON",
        "first_name": "REBECCA",
        "credential": "MA, LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-18",
        "last_updated": "2023-02-01",
        "certification_date": "2023-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "3244",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elk River, MN

Sources for this page

Verify at the official NPI Registry.