Individual
HIZA BENITA MARIA JACKSON-PRICE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LPC, LCAS
Contact information
Practice address
115 SEAWARD DR, HOLLY RIDGE, NC 28445-7998
(910) 265-1235
Mailing address
455 E JEFFERSON ST, BUTLER, PA 16001-4724
(910) 265-1235
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
2368
NC
101YP2500X
Professional Counselor
Primary
7680
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1093065484
NATIONAL PROVIDER IDENTIFIER ENUMERATOR
NC
Enumeration date
09/13/2012
Last updated
02/03/2019
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