John Michael Benda, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

13217 Issued in MN

Practice address

4005 W 65TH St
Suite #216
Edina, MN 55435-1720

Phone

(612) 929-0781

NPI assigned

Jul 12, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Franklin Family Services LLC

  • Community/Behavioral Health Agency
  • St Louis Park, MN
  • NPI 1679870570
  NPD (past)
• Relate Inc

  • Community/Behavioral Health Agency
  • Minnetonka, MN
  • NPI 1053486902
  NPD (past)

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

{
    "created_epoch": "1121126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214870400000",
    "number": "1194723288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2911 W 40TH ST",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554101111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4005 W 65TH ST",
            "address_2": "SUITE #216",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554351720",
            "telephone_number": "612-929-0781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENDA",
        "first_name": "JOHN",
        "middle_name": "MICHAEL",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-12",
        "last_updated": "2008-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "13217",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "57G30BE",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Peter J Belin, MD
• Micaela Bell
• Joseph Edward Bellamy, M.D.
• John W Bellatti, M.D.
• Belonging Psychotherapy PLLC
• Gail Papermaster Bender, M.D.
• Kaitlyn Benert, LPCC
• Paul L. Benn, M.D.
• Alexis Bennett, LICSW
• Stephen D Bennett, MD

• Clinical Social Worker in Edina, MN
• Providers in Edina, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.