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General NPI Number Information
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NPI Number | 1194867341
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Entity Type | Individual
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Provider Name | LYNECE BENTON-STEWART LPC - MHSP
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Gender | Female
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Dates
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Enumeration Date | 02/13/2007
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Last Update Date | 06/11/2019
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Provider Practice Location Address
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Address Line | 3250 DICKERSON PIKE STE 13
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City | NASHVILLE
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State | TN
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Zip | 37207
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Country | US
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Telephone | 615-598-0177
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Fax | 615-651-8062
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Provider Business Mailing Address
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Address Line | 1421 MCGAVOCK PIKE
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City | NASHVILLE
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State | TN
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Zip | 37216-3224
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Country | US
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Telephone | 615-598-0177
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Fax | 615-673-4904
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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 | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 1806
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License Number State | TN
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