Healthcare Provider Details

I. General information

NPI: 1336727460
Provider Name (Legal Business Name): HEATHER BENATTI-MCCALL LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2021
Last Update Date: 09/09/2025
Certification Date: 09/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5710 OLEANDER DR STE 112
WILMINGTON NC
28403-4722
US

IV. Provider business mailing address

PSC 480 BOX 1389
APO AE
09128-0014
US

V. Phone/Fax

Practice location:
  • Phone: 910-452-1460
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0904017591
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC015139
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: