Individual provider Active NPI

Marcus Benson, LPC, LPCC

  • Professional Counselor
  • Rogers, AR
National Provider Identifier
1366965196
Registry record updated Jun 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
P1909117 Issued in AR
Practice address
1102 Poplar PL
Rogers, AR 72756-4249
Phone
(479) 372-6464
Fax
(479) 372-6460
NPI assigned
Jul 24, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 9, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 4910 MN
Professional Counselor 101YP2500X P1909117 AR Primary

Addresses

Primary practice location

1102 Poplar PL
Rogers, AR 72756-4249

Mailing address

2809 Forest Home Rd
Jonesboro, AR 72401-5320
Phone (866) 972-1268

Other practice location 1

1108 Poplar Pl
Rogers, AR 72756-4249
Phone (479) 372-6464

Other practice location 2

2020 E Joyce Blvd Ste 1
Fayetteville, AR 72703-6228
Phone (479) 332-4557

Other identifiers 1

IdentifierTypeStateIssuer
270272719MedicaidAR

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20250710003075 MN Practitioner - Mental Health Counselor 3072957208 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Affinity Psychological Services, P.C. Mental Health CurrentSince Aug 4, 2025 Accepting new patients
Ozark Guidance Center, Inc Past Accepting new patients
Optum Behavioral Care of North Carolina, P.C. PastSince Dec 21, 2025 Accepting new patients

Locations

7401 Metro Blvd
Ste 250
Minneapolis, MN 55439
Phone (612) 778-8393

7401 Metro Blvd
Ste 525
Minneapolis, MN 55439

3400 1st St N
Ste 101
Saint Cloud, MN 56303
Phone (320) 202-2000

5775 Wayzata Blvd
Ste 880
St Louis Park, MN 55416

Interoperability endpoints

  • Direct secure messaging: mbenson1043629@directc.mercy.net

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1500854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749427200000",
    "number": "1366965196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2809 FOREST HOME RD",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724015320",
            "telephone_number": "866-972-1268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1102 POPLAR PL",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727564249",
            "telephone_number": "479-372-6464",
            "fax_number": "479-372-6460"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1108 Poplar Pl",
            "address_purpose": "LOCATION",
            "city": "Rogers",
            "state": "AR",
            "postal_code": "727564249",
            "country_code": "US",
            "telephone_number": "479-372-6464",
            "fax_number": "479-372-6460",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2020 E Joyce Blvd Ste 1",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "AR",
            "postal_code": "727036228",
            "country_code": "US",
            "telephone_number": "479-332-4557",
            "fax_number": "479-435-9587",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BENSON",
        "first_name": "MARCUS",
        "credential": "LPC, LPCC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-07-24",
        "last_updated": "2025-06-09",
        "certification_date": "2025-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "4910",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AR",
            "license": "P1909117",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "270272719",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rogers, AR

Sources for this page

Verify at the official NPI Registry.