Organization Active NPI

John M. Benda Psychotherapy Services, Inc.

  • Clinical Social Worker
  • Edina, MN
National Provider Identifier
1861644668
Registry record updated Nov 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
13217 Issued in MN
Legal business name
JOHN M. BENDA PSYCHOTHERAPY SERVICES, INC.
Practice address
4005 W 65TH St
#216
Edina, MN 55435-1720
Phone
(612) 929-0781
Fax
(952) 285-6780
NPI assigned
Oct 13, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2008

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

Authorized official

Name
Mr. John M. Benda, LICSW
Title
Clinical Social Worker
Phone
(612) 929-0781

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X 13217 MN Primary

Addresses

Primary practice location

4005 W 65TH St
#216
Edina, MN 55435-1720

Mailing address

2911 W 40TH St
Minneapolis, MN 55410-1111
Phone (612) 929-0781

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1223856000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1225929600000",
    "number": "1861644668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2911 W 40TH ST",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554101111",
            "telephone_number": "612-929-0781",
            "fax_number": "952-285-6780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4005 W 65TH ST",
            "address_2": "#216",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554351720",
            "telephone_number": "612-929-0781",
            "fax_number": "952-285-6780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN M. BENDA PSYCHOTHERAPY SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-13",
        "last_updated": "2008-11-06",
        "status": "A",
        "authorized_official_last_name": "BENDA",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "CLINICAL SOCIAL WORKER",
        "authorized_official_telephone_number": "612-929-0781",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LICSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "13217",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edina, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2008; 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.