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Individual

MRS. PETRONELLAH THOKO BENSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPCC

Contact information

Practice address
7030 BROOKLYN BLVD, BROOKLYN CENTER, MN 55429-1370
(763) 438-5529
Mailing address
7030 BROOKLYN BLVD, BROOKLYN CENTER, MN 55429-1370
(763) 438-5529
(763) 292-5653

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
CC1891
MN
101YM0800X
Mental Health Counselor
1891
MN
101YM0800X
Mental Health Counselor
CC1891
MN
101YP2500X
Professional Counselor
Primary
CC01891
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000
BEHAVIORAL HEALTH
MN
05
674492400
MN
01
874647200
MEDICARE
MN
Enumeration date
08/20/2018
Last updated
09/06/2025
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