1841590205 NPI number — BENFIELD COUNSELING SERVICES

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1841590205 NPI number — BENFIELD COUNSELING SERVICES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BENFIELD COUNSELING SERVICES
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1841590205
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/01/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
715 FAIRGROVE CHURCH RD SE
Provider Second Line Business Mailing Address:
SUITE 202
Provider Business Mailing Address City Name:
CONOVER
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28613-9290
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
828-238-9919
Provider Business Mailing Address Fax Number:
828-322-2280

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
715 FAIRGROVE CHURCH RD SE
Provider Second Line Business Practice Location Address:
SUITE 202
Provider Business Practice Location Address City Name:
CONOVER
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28613-9290
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
828-238-9919
Provider Business Practice Location Address Fax Number:
828-322-2280
Provider Enumeration Date:
11/01/2010

Additional Information

Authorized Official

Authorized Official Last Name:
BENFIELD
Authorized Official First Name:
KITTY
Authorized Official Middle Name:
CONLEY
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
828-238-9919

Provider Taxonomy Codes

  • Taxonomy code: 101YP2500X , with the licence number:  3167 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 6103385 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".




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