Individual
MRS. LISA BENTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCAS
Contact information
Practice address
201 N FRONT ST STE 713, WILMINGTON, NC 28401-5090
(910) 619-7500
Mailing address
609A PINER RD STE 182, WILMINGTON, NC 28409-4201
(910) 619-7500
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1358
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6112068
—
NC
Enumeration date
01/21/2009
Last updated
11/16/2020
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