Organization
INNOVATIVE BEHAVIORAL HEALTH SERVICES P.C.
Active
Organization
INNOVATIVE BEHAVIORAL HEALTH SERVICES P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BENJAMIN JOSEPH MASTRIDGE MSN, PMHNP-BC (PRESIDENT)
(919) 529-2474
Entity
Organization
Contact information
Practice address
402 MAIN ST, CREEDMOOR, NC 27522
(919) 529-2474
Mailing address
PO BOX 400, CREEDMOOR, NC 27522-0400
(919) 529-2474
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Enumeration date
02/07/2013
Last updated
02/23/2022
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