Healthcare Provider Details

I. General information

NPI: 1871985135
Provider Name (Legal Business Name): DANIELLE BENT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/24/2015
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 23RD AVE
MINNEAPOLIS MN
55454
US

IV. Provider business mailing address

525 23RD AVE
MINNEAPOLIS MN
55454
US

V. Phone/Fax

Practice location:
  • Phone: 612-273-6061
  • Fax: 612-273-6692
Mailing address:
  • Phone: 612-273-6061
  • Fax: 612-273-6692

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH16736
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2021018286
License Number StateMO
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberIMH12749
License Number StateFL
# 4
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number3969
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: