Provider Demographics
NPI:1104408947
Name:BENSON, ASHLEY VERONICA
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:VERONICA
Last Name:BENSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:
Other - Last Name:MAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11301 S HARLEM AVE
Mailing Address - Street 2:
Mailing Address - City:WORTH
Mailing Address - State:IL
Mailing Address - Zip Code:60482
Mailing Address - Country:US
Mailing Address - Phone:708-586-2604
Mailing Address - Fax:
Practice Address - Street 1:260 2ND AVENUE CT SW
Practice Address - Street 2:
Practice Address - City:RICE
Practice Address - State:MN
Practice Address - Zip Code:56367
Practice Address - Country:US
Practice Address - Phone:763-276-4541
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-21
Last Update Date:2025-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLBA0168103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst