Individual
DR. NICOLE N BENTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
1194 147TH ST STE 5, MONTICELLO, GA 31064-8068
(678) 561-3091
(404) 795-8974
Mailing address
3826 SALEM RD # 136, COVINGTON, GA 30016-4528
(678) 561-3091
(404) 795-8974
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
008941
GA
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
007682
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003181947J
—
GA
Enumeration date
04/20/2016
Last updated
01/26/2023
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