Healthcare Provider Details

I. General information

NPI: 1649199332
Provider Name (Legal Business Name): BENJAMIN ADDISON DRIGGERS LCSWA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/15/2026
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

134 W MATTHEWS ST
MATTHEWS NC
28105-1305
US

IV. Provider business mailing address

6121 WOLVERHAMPTON DR
RALEIGH NC
27603-9298
US

V. Phone/Fax

Practice location:
  • Phone: 704-708-4605
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberP024055
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: