NPIMap

Organization Active NPI

Benson Psychological Services, PC

  • Psychologist
  • Moorhead, MN
National Provider Identifier
1437540929
Registry record updated Feb 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
BENSON PSYCHOLOGICAL SERVICES, PC
Practice address
200 5TH St S
Suite 205
Moorhead, MN 56560
Phone
(701) 297-7540
Fax
(701) 297-6439
NPI assigned
Feb 5, 2015
Organization subpart
Yes
Parent organization
BENSON PSYCHOLOGICAL SERVICES, PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 5, 2015

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

Authorized official

Name
Richard Michael Benson
Title
Executive Director
Phone
(701) 297-7540

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X CC00827 MN
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X Primary

Addresses

Primary practice location

200 5TH St S
Suite 205
Moorhead, MN 56560

Mailing address

1308 23Rd St S
Fargo, ND 58103-3707
Phone (701) 297-7540

Other identifiers 1

IdentifierTypeStateIssuer
10250MedicaidND

National Provider Directory

National Provider Directory
Tax ID family
Benson Psych2 organizations share this tax ID, including this one
Part of
Benson Psych

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1423094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1423094400000",
    "number": "1437540929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1308 23RD ST S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581033707",
            "telephone_number": "701-297-7540",
            "fax_number": "701-297-6439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 5TH ST S",
            "address_2": "SUITE 205",
            "city": "MOORHEAD",
            "state": "MN",
            "postal_code": "56560",
            "telephone_number": "701-297-7540",
            "fax_number": "701-297-6439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BENSON PSYCHOLOGICAL SERVICES, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BENSON PSYCHOLOGICAL SERVICES, PC",
        "enumeration_date": "2015-02-05",
        "last_updated": "2015-02-05",
        "status": "A",
        "authorized_official_last_name": "BENSON",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "701-297-7540"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "CC00827",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10250",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Moorhead, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2015; 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.