Individual
MR. BENJAMIN K BENTLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCAS, LCMHCS
Contact information
Practice address
6614 SHALLOWFORD RD STE 250, LEWISVILLE, NC 27023-9305
(336) 945-0137
(336) 946-9084
Mailing address
5335 ROBINHOOD VILLAGE DR STE 155, WINSTON SALEM, NC 27106-9820
(336) 905-9532
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
685
NC
101YP2500X
Professional Counselor
Primary
4754
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6102194
—
NC
Enumeration date
08/14/2006
Last updated
07/24/2023
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