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General NPI Number Information
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NPI Number | 1528577764
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Entity Type | Individual
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Provider Name | CHRISTA A'LAYNE BENTON LPC, NCC
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Gender | Female
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Dates
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Enumeration Date | 09/20/2017
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Last Update Date | 08/12/2021
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Provider Practice Location Address
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Address Line | 1806 SUMMIT AVE STE 300
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City | RICHMOND
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State | VA
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Zip | 23230-4339
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Country | US
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Telephone | 804-208-0805
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Fax | 804-441-8988
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Provider Business Mailing Address
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Address Line | PO BOX 38188
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City | HENRICO
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State | VA
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Zip | 23231-0988
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Country | US
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Telephone | 804-208-0805
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Fax | 804-441-8988
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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 | 0701007284
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License Number State | VA
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