Healthcare Provider Details

I. General information

NPI: 1750191540
Provider Name (Legal Business Name): MICHELLE LYNN BEN MA, LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MICHELLE LYNN RASCON MA, LMHC

II. Dates (important events)

Enumeration Date: 01/13/2025
Last Update Date: 02/11/2026
Certification Date: 02/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6612 GULTON CT NE STE B
ALBUQUERQUE NM
87109-4407
US

IV. Provider business mailing address

6612 GULTON CT NE STE B
ALBUQUERQUE NM
87109-4407
US

V. Phone/Fax

Practice location:
  • Phone: 505-633-7886
  • Fax:
Mailing address:
  • Phone: 505-633-7886
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberCTB-2026-0041
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: