Benjamin Bader, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

2711 Issued in MN

Practice address

12915 63Rd Ave. N.
Maple Grove, MN 55369

Phone

(952) 826-8412

Fax

(763) 383-5802

NPI assigned

Jan 22, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Collaborative Counseling LLC

  • Mental Health Counselor
  • Maple Grove, MN
  • NPI 1598034324

  MN

  Medicare reassignment NPD

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

{
    "created_epoch": "1390348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519862400000",
    "number": "1093138331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12915 63RD AVE. N.",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "55369",
            "telephone_number": "952-826-8412",
            "fax_number": "763-383-5802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12915 63RD AVE. N.",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "55369",
            "telephone_number": "952-826-8412",
            "fax_number": "763-383-5802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BADER",
        "first_name": "BENJAMIN",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-01-22",
        "last_updated": "2018-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "2711",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katherine Lynn Awoyinka, AU.D.
• William Babb, PA-C
• Howard L. Bach, M.D.
• Back in Motion Chiropractic
• Back Porch Solutions LLC
• Rebecca M. Bader, OD
• Christopher J Bailey, PT
• Bradley Baker
• Bjorn Bakken, MD
• Kristopher Gerald Balgaard, PT

• All providers in Maple Grove, MN
• Marriage & Family Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.