Healthcare Provider Details

I. General information

NPI: 1023288271
Provider Name (Legal Business Name): BENITA JO HUTCHINSON LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/04/2008
Last Update Date: 10/31/2024
Certification Date: 10/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 N SALISBURY AVE
SPENCER NC
28159-2514
US

IV. Provider business mailing address

1117 HOLMES AVE
SALISBURY NC
28144-2614
US

V. Phone/Fax

Practice location:
  • Phone: 704-216-2630
  • Fax:
Mailing address:
  • Phone: 136-246-6543
  • Fax: 313-631-0168

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801085306
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC013520
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: