Provider Demographics
NPI:1346659646
Name:SANTEE, BENJAMIN LUCAS (MA, LPC)
Entity type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:LUCAS
Last Name:SANTEE
Suffix:
Gender:M
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2401 CAMELOT CT SE STE E
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49546-6083
Mailing Address - Country:US
Mailing Address - Phone:616-949-7460
Mailing Address - Fax:616-949-3018
Practice Address - Street 1:2401 CAMELOT CT SE STE E
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49546-6083
Practice Address - Country:US
Practice Address - Phone:616-648-2289
Practice Address - Fax:616-279-3723
Is Sole Proprietor?:No
Enumeration Date:2014-08-12
Last Update Date:2024-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401017027101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI6401017027OtherPROFESSIONAL COUNSELOR LICENSE