Individual
BENJAMIN JARED GROSSNICKLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW-A, LCAS-A
Contact information
Practice address
2602 COURTIER DR, GREENVILLE, NC 27834-7818
(252) 752-0483
(252) 757-3172
Mailing address
2602 COURTIER DR, GREENVILLE, NC 27834-7818
(252) 752-0483
(252) 757-3172
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LCAS-29816
NC
1041C0700X
Clinical Social Worker
Primary
C017988
NC
Other
Enumeration date
06/12/2024
Last updated
01/30/2025
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