Petronellah Thoko Bensen, LPCC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

CC01891 Issued in MN

Practice address

7030 Brooklyn Blvd
Brooklyn Center, MN 55429-1370

Phone

(763) 438-5529

NPI assigned

Aug 20, 2018

Last updated

Sep 6, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 3

Other names 1

• Petronellah Thoko Bensen Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Kesma Flame Lily LLC

  • Professional Counselor
  • Brooklyn Center, MN
  • NPI 1295212355

  Mental Health

  NPD Authorized official

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

{
    "created_epoch": "1534723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757116800000",
    "number": "1538649595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7030 BROOKLYN BLVD",
            "city": "BROOKLYN CENTER",
            "state": "MN",
            "postal_code": "554291370",
            "telephone_number": "763-438-5529",
            "fax_number": "763-292-5653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7030 BROOKLYN BLVD",
            "city": "BROOKLYN CENTER",
            "state": "MN",
            "postal_code": "554291370",
            "telephone_number": "763-438-5529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENSEN",
        "first_name": "PETRONELLAH",
        "middle_name": "THOKO",
        "name_prefix": "Mrs.",
        "credential": "LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-20",
        "last_updated": "2025-09-06",
        "certification_date": "2025-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MN",
            "license": "CC1891",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "1891",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "CC1891",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "CC01891",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "874647200",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BEHAVIORAL HEALTH",
            "identifier": "000000",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "674492400",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PETRONELLAH",
            "last_name": "BENSEN",
            "middle_name": "THOKO",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Professional Counselor in Brooklyn Center, MN
• Providers in Brooklyn Center, MN by specialty
• Professional Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2025; 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.