Provider Demographics
NPI:1013457498
Name:BENSEN, ALLISON (LPC)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:
Last Name:BENSEN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:515 NATIONAL ST STE 103
Mailing Address - Street 2:
Mailing Address - City:BELLE FOURCHE
Mailing Address - State:SD
Mailing Address - Zip Code:57717-1833
Mailing Address - Country:US
Mailing Address - Phone:605-695-3675
Mailing Address - Fax:
Practice Address - Street 1:515 NATIONAL ST STE 103
Practice Address - Street 2:
Practice Address - City:BELLE FOURCHE
Practice Address - State:SD
Practice Address - Zip Code:57717-1833
Practice Address - Country:US
Practice Address - Phone:605-695-3675
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-03
Last Update Date:2017-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDLPC7089101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor