Active NPI
Benjamin Pedraza
- Professional Counselor
- Phoenix, AZ
National Provider Identifier
1902429418
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LPC-22959
- Practice address
- 3620 E Blanche Dr
Phoenix, AZ 85032-4603 - Phone
- (602) 821-9154
- NPI assigned
- May 19, 2020
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LPC-22959 | AZ | Primary |
Addresses
Primary practice location
3620 E Blanche Dr
Phoenix, AZ 85032-4603
Mailing address
3620 E Blanche Dr
Phoenix, AZ 85032-4603
Phone (602) 821-9154
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 2019
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
803 Sunken Rd
Fredericksburg, VA 22401-5401
PO Box
Atlanta, GA 30374
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPC-22959 | AZ | MD | Professional Counselor |
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1589846400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1772668800000",
"number": "1902429418",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3620 E BLANCHE DR",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850324603",
"telephone_number": "602-821-9154"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3620 E BLANCHE DR",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850324603",
"telephone_number": "602-821-9154"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEDRAZA",
"first_name": "BENJAMIN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-05-19",
"last_updated": "2026-03-05",
"certification_date": "2026-03-05",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Counselor, Professional",
"state": "AZ",
"license": "LPC-22959",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.