Provider Demographics
NPI:1346659646
Name:SANTEE, BENJAMIN LUCAS (MA, LPC)
Entity Type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:LUCAS
Last Name:SANTEE
Suffix:
Gender:M
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3210 EAGLE RUN DR SE
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49502-0001
Mailing Address - Country:US
Mailing Address - Phone:616-597-1200
Mailing Address - Fax:517-597-1297
Practice Address - Street 1:3210 EAGLE RUN DR SE
Practice Address - Street 2:SUITE 200
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49525-2810
Practice Address - Country:US
Practice Address - Phone:616-279-3725
Practice Address - Fax:616-279-3723
Is Sole Proprietor?:No
Enumeration Date:2014-08-12
Last Update Date:2019-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401017027101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI6401017027OtherPROFESSIONAL COUNSELOR LICENSE