Benjamin Long

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

CC01004 Issued in MN

Practice address

540 E 1St St
Waconia, MN 55387

Phone

(952) 442-4437

Fax

(952) 442-3084

NPI assigned

Jun 8, 2015

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Carver County

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Waconia, MN
  • NPI 1326049685
  NPD (past)

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

{
    "created_epoch": "1433721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534377600000",
    "number": "1801276563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "540 E 1ST ST",
            "city": "WACONIA",
            "state": "MN",
            "postal_code": "553871600",
            "telephone_number": "952-442-4437",
            "fax_number": "952-442-3084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 E 1ST ST",
            "city": "WACONIA",
            "state": "MN",
            "postal_code": "55387",
            "telephone_number": "952-442-4437",
            "fax_number": "952-442-3084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONG",
        "first_name": "BENJAMIN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-06-08",
        "last_updated": "2018-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "CC01004",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Briana Kay Linnerooth, PT
• Carolyn Little
• Ryan Loegering, PHARMD
• Stephanie Loegering, PHARMD
• Melissa Londono, OTR/L
• Bradley J Ludwig, O.D.
• Emily Taylor Ludwigson
• Mackenthun Beck Pharmacy, Inc
• Mackenthun Supermarkets, Inc.
• Yalda Mahinfalah

• Mental Health Counselor in Waconia, MN
• Providers in Waconia, MN by specialty
• Mental Health Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2018; 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.