Active NPI
Rachel Benolken
- Behavior Analyst
- Moorhead, MN
National Provider Identifier
1447701016
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- L46
- Practice address
- 1530 1St Ave N Ste 150
Moorhead, MN 56560-0002 - Phone
- (218) 371-1690
- NPI assigned
- Oct 19, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | L46 | ND | Primary |
Addresses
Primary practice location
1530 1St Ave N Ste 150
Moorhead, MN 56560-0002
Mailing address
891 Belsly Blvd
Moorhead, MN 56560-5055
Phone (218) 287-4338
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1469681 | Medicaid | ND |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| L46 | ND | MD | Behavioral Analyst |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Caravel Autism Health, LLC | Behavior Analyst | Past | Accepting new patients |
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 and National Provider Directory roles.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1476835200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1699574400000",
"number": "1447701016",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "891 BELSLY BLVD",
"city": "MOORHEAD",
"state": "MN",
"postal_code": "565605055",
"telephone_number": "218-287-4338",
"fax_number": "218-287-5928"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1530 1ST AVE N STE 150",
"city": "MOORHEAD",
"state": "MN",
"postal_code": "565600002",
"telephone_number": "218-371-1690"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BENOLKEN",
"first_name": "RACHEL",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-10-19",
"last_updated": "2023-11-10",
"certification_date": "2023-11-10",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "ND",
"license": "L46",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1469681",
"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 Nov 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.