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General NPI Number Information
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NPI Number | 1295669737
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Entity Type | Individual
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Provider Name | HEATHER C BENEVENTO LPC, LPC-MHSP
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Gender | Female
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Dates
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Enumeration Date | 06/10/2026
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Last Update Date | 06/10/2026
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Provider Practice Location Address
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Address Line | 454 E MAIN ST
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City | ABINGDON
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State | VA
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Zip | 24210-3408
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Country | US
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Telephone | 276-300-4422
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Fax |
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Provider Business Mailing Address
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Address Line | 1825 W LAKEVIEW DR APT A10
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City | JOHNSON CITY
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State | TN
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Zip | 37601-2194
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Country | US
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Telephone | 423-388-5012
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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 | 0701016275
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License Number State | VA
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