Individual
BENITA BULLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
181 WIND CHIME CT, RALEIGH, NC 27615-6474
(253) 576-3898
Mailing address
7635 GRESHAM HILLS DR # 102, RALEIGH, NC 27615-3763
(252) 245-0923
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
A22258
NC
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
A22258
NC
101YM0800X
Mental Health Counselor
MHCA.MC.61535559
WA
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
02/21/2024
Last updated
03/31/2026
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