Provider Demographics
NPI:1861842957
Name:RASCHE, BENJAMIN (LCPC)
Entity Type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:
Last Name:RASCHE
Suffix:
Gender:M
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1999 WABASH AVE
Mailing Address - Street 2:SUITE 209
Mailing Address - City:SPRINGFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:62704-5351
Mailing Address - Country:US
Mailing Address - Phone:217-891-6063
Mailing Address - Fax:
Practice Address - Street 1:1999 WABASH AVE
Practice Address - Street 2:SUITE 209
Practice Address - City:SPRINGFIELD
Practice Address - State:IL
Practice Address - Zip Code:62704-5351
Practice Address - Country:US
Practice Address - Phone:217-891-6063
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-20
Last Update Date:2016-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.009925101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor