Healthcare Provider Details

I. General information

NPI: 1972449791
Provider Name (Legal Business Name): COHESION BEHAVIORAL AND WELLNESS CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/24/2026
Last Update Date: 04/24/2026
Certification Date: 04/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

202 NORTH MAIN STREET
MOUNT GILEAD NC
27306
US

IV. Provider business mailing address

202 NORTH MAIN STREET
MOUNT GILEAD NC
27306
US

V. Phone/Fax

Practice location:
  • Phone: 704-207-4605
  • Fax:
Mailing address:
  • Phone: 704-207-4605
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. ALEXIS BENJAMIN
Title or Position: PA
Credential:
Phone: 704-207-4605