Provider Demographics
NPI:1386350445
Name:MATHER, BENJAMIN KALE (LPC-IT)
Entity type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:KALE
Last Name:MATHER
Suffix:
Gender:M
Credentials:LPC-IT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:725 HEARTLAND TRL STE 301
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53717-1978
Mailing Address - Country:US
Mailing Address - Phone:608-205-4450
Mailing Address - Fax:
Practice Address - Street 1:725 HEARTLAND TRL
Practice Address - Street 2:STE 301
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53717-1978
Practice Address - Country:US
Practice Address - Phone:608-205-4450
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-23
Last Update Date:2024-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor