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General NPI Number Information
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NPI Number | 1255155834
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Entity Type | Individual
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Provider Name | BENJAMIN WAYNE RONNING LPCC
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Gender | Male
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Dates
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Enumeration Date | 11/11/2024
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Last Update Date | 11/11/2024
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Provider Practice Location Address
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Address Line | 1915 LYNDALE AVE S
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City | MINNEAPOLIS
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State | MN
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Zip | 55403-3104
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Country | US
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Telephone | 800-336-5973
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Fax |
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Provider Business Mailing Address
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Address Line | 425 SUZANNE AVE
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City | SHOREVIEW
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State | MN
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Zip | 55126-2312
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Country | US
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Telephone | 218-205-4213
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 4691
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License Number State | MN
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