Individual
PHILLIP MICHAEL BENAVIDES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2225 PARKER RD, CARROLLTON, TX 75010-4711
(972) 242-4114
Mailing address
4208 STONE TRAIL DR, DENTON, TX 76210-1517
(214) 621-3065
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
77347
TX
101YA0400X
Addiction (Substance Use Disorder) Counselor
77347
TX
101YM0800X
Mental Health Counselor
77347
TX
101YP2500X
Professional Counselor
77347
TX
Other
Enumeration date
03/22/2020
Last updated
03/22/2020
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