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General NPI Number Information
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NPI Number | 1033395868
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Entity Type | Individual
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Provider Name | MICHAEL BENJAMIN HOLLINGSWORTH LPC
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Gender | Male
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Dates
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Enumeration Date | 01/10/2008
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Last Update Date | 01/10/2008
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Provider Practice Location Address
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Address Line | 3500 ELLINGTON ST
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City | CHARLOTTE
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State | NC
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Zip | 28211-1102
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Country | US
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Telephone | 704-926-5030
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Fax | 704-927-0482
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Provider Business Mailing Address
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Address Line | PO BOX 562563
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City | CHARLOTTE
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State | NC
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Zip | 28256-2563
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Country | US
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Telephone | 704-926-5030
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Fax | 704-927-0482
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 6810
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License Number State | NC
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