Individual provider Active NPI

Kaj Benson, LMFT

  • Marriage & Family Therapist
  • Minneapolis, MN
National Provider Identifier
1962927129
Registry record updated Feb 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
3768 Issued in MN
Practice address
730 E 38TH St Ste 103
Minneapolis, MN 55407-5218
Phone
(612) 421-8083
NPI assigned
Aug 9, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 3768 MN Primary

Addresses

Primary practice location

730 E 38TH St Ste 103
Minneapolis, MN 55407-5218

Mailing address

730 E 38TH St Ste 103
Minneapolis, MN 55407-5218
Phone (612) 421-8083

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kaj@edgeswellness.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240816002966 MN Practitioner - Marriage and Family Therapist 5890233134 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Edges Wellness Center LLCGroup PAC ID 9638613607, 8 clinicians

Practice addresses (Care Compare)

730 E 38TH St
Suite 101
Minneapolis, MN 55407-5218
Phone (612) 217-0584

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3768MNMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Edges Wellness Center LLC Marriage & Family Therapist CurrentSince Aug 1, 2024 Accepting new patients

Locations

730 E 38th St
Ste 101
Minneapolis, MN 55407
Phone (612) 217-0584

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": "1502236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644883200000",
    "number": "1962927129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "730 E 38TH ST STE 103",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554075218",
            "telephone_number": "612-421-8083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "730 E 38TH ST STE 103",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554075218",
            "telephone_number": "612-421-8083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENSON",
        "first_name": "KAJ",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-09",
        "last_updated": "2022-02-15",
        "certification_date": "2021-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "3768",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kaj@edgeswellness.com",
            "affiliation": "N",
            "endpointDescription": "confidential work email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "730 E 38th St Ste 103",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554075218",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.