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Individual

BENEDICT A WALZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MS MDV MAC LADC LMFT

Contact information

Practice address
3333 W DIVISION ST, MIDTOWN SQUARE SUITE # 210, SAINT CLOUD, MN 56301-4515
(320) 252-5781
(320) 252-5001
Mailing address
3333 W DIVISION ST, MIDTOWN SQUARE SUITE # 210, SAINT CLOUD, MN 56301-4515
(320) 252-5781
(320) 252-5001

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
#302151
101YA0400X
Addiction (Substance Use Disorder) Counselor
302151
MN
101YM0800X
Mental Health Counselor
101YP1600X
Pastoral Counselor
WI
101YP1600X
Pastoral Counselor
101YP2500X
Professional Counselor
#1763 LMFT
MN
101YP2500X
Professional Counselor
251S00000X
Community/Behavioral Health Agency
1763
251S00000X
Community/Behavioral Health Agency
Primary
1763 & 302151

Other

Enumeration date
12/28/2006
Last updated
03/17/2010
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