Provider Demographics
NPI:1912099359
Name:BENSON, CHRISTA NOEL (MS LMFT)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTA
Middle Name:NOEL
Last Name:BENSON
Suffix:
Gender:F
Credentials:MS LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 640
Mailing Address - Street 2:
Mailing Address - City:BEMIDJI
Mailing Address - State:MN
Mailing Address - Zip Code:56619-0640
Mailing Address - Country:US
Mailing Address - Phone:218-751-3280
Mailing Address - Fax:218-751-3298
Practice Address - Street 1:722 15TH ST
Practice Address - Street 2:
Practice Address - City:BEMIDJI
Practice Address - State:MN
Practice Address - Zip Code:56601-2528
Practice Address - Country:US
Practice Address - Phone:218-731-3280
Practice Address - Fax:218-751-3298
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2008-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1077106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist