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Individual

MR. BENJAMIN JACOBS MANNING

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MSW, LCAS, LCSW

Contact information

Practice address
165 SHIPYARD BOULEVARD, WILMINGTON, NC 28412-6431
(919) 360-7247
Mailing address
165 SHIPYARD BOULEVARD, WILMINGTON, NC 28412-6431
(919) 360-7247

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
1148
NC
1041C0700X
Clinical Social Worker
Primary
C005931
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
14742
BCBSNC
05
6007254
NC
Enumeration date
03/12/2007
Last updated
07/18/2015
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