Healthcare Provider Details

I. General information

NPI: 1306783576
Provider Name (Legal Business Name): MARYANN KRUSE BENS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2026
Last Update Date: 05/04/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2723 S STATE ST STE 150
ANN ARBOR MI
48104-6188
US

IV. Provider business mailing address

2723 SOUTH STATE STREET STE 150 PMB 9901
ANN ARBOR MI
48104
US

V. Phone/Fax

Practice location:
  • Phone: 510-944-0221
  • Fax: 510-944-0020
Mailing address:
  • Phone: 510-944-0221
  • Fax: 510-944-0020

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. MARYANN KRUSE BENS
Title or Position: MANAGER
Credential: PSYD
Phone: 510-427-8728