IndividualActive
Benjamin Long
NPI 1801276563 · Mental Health Counselor · Waconia, MN
Provider details
- NPI number
- 1801276563
- Entity type
- Individual
- Primary specialty
- Mental Health CounselorBehavioral Health & Social Service Providers
- Sex
- Male
- Sole proprietor
- Yes
- License
- CC01004 (MN)
Specialties & taxonomies
Behavioral Health & Social Service Providers
Practice location
540 E 1st St
Waconia, MN 55387
Phone: (952) 442-4437
Fax: (952) 442-3084
Approximate (ZIP-level) locationGet directions
Mailing address
540 E 1st St
Waconia, MN 55387-1600
Registry dates
- Enumerated
- 2015-06-08
- Last updated
- 2018-08-16
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.