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General NPI Number Information
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NPI Number | 1871090167
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Entity Type | Organization
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Legal Business Name | FAITH BASED COUNSELING SERVICES, LLC
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Dates
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Enumeration Date | 04/12/2018
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Last Update Date | 04/12/2018
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Provider Practice Location Address
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Address Line | 235 COMMERECE STREET
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City | GREENVILLE
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State | NC
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Zip | 27858
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Country | US
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Telephone | 252-493-6300
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1133
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City | WINTERVILLE
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State | NC
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Zip | 28590
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Country | US
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Telephone | 252-493-6300
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Fax | 252-493-6300
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Authorized Official
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Title or Position | OWNER & CLINICAL DIRECTOR
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Name | MS. LA'NEIKA BENBOW
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Credential | LCSW, MFT
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Telephone | 252-493-6300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 10548
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | C007676
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License Number State | NC
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