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General NPI Number Information
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NPI Number | 1255172821
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Entity Type | Individual
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Provider Name | KRISTA SAAB BENNETT M.A., NCC, NCMHCA
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Gender | Female
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Dates
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Enumeration Date | 06/05/2024
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Last Update Date | 06/05/2024
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Provider Practice Location Address
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Address Line | 4030 WAKE FOREST RD STE 206
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City | RALEIGH
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State | NC
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Zip | 27609-6800
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Country | US
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Telephone | 919-713-0260
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Fax |
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Provider Business Mailing Address
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Address Line | 1508 SILVER ELM LN
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City | WENDELL
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State | NC
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Zip | 27591-4408
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Country | US
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Telephone | 818-445-6432
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Fax |
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | A20069
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License Number State | NC
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