Provider Demographics
NPI:1356894927
Name:BENZ, ALLISON C (LMFT)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:C
Last Name:BENZ
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12565 224TH CT NW
Mailing Address - Street 2:
Mailing Address - City:ELK RIVER
Mailing Address - State:MN
Mailing Address - Zip Code:55330-8763
Mailing Address - Country:US
Mailing Address - Phone:763-232-3556
Mailing Address - Fax:612-239-0141
Practice Address - Street 1:9000 QUANTRELLE AVE NE
Practice Address - Street 2:STE 102
Practice Address - City:OTSEGO
Practice Address - State:MN
Practice Address - Zip Code:55330-1029
Practice Address - Country:US
Practice Address - Phone:612-217-4241
Practice Address - Fax:612-239-0141
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-29
Last Update Date:2023-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3511106H00000X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health