MEDICARE: MS. ELIZABETH MARIE BENNETT-HILL LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	847	NC

General Provider Information

NPI Number	:	1265437149
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ELIZABETH MARIE BENNETT-HILL LPC

Provider Business Mailing Address
First Line	:	9105 BEAVER BROOK WAY
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28277-1733
Country	:	US
Telephone Number	:	704-307-0521
Fax Number	:	704-319-2250

Provider Business Practice Location Address
First Line	:	7810 BALLANTYNE COMMONS PKWY
Second Line	:	STE 300
City	:	CHARLOTTE
State	:	NC
Zip	:	28277-3416
Country	:	US
Telephone Number	:	704-319-2243
Fax Number	:	704-219-2250

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/16/2005
Last Update Date	:	07/08/2007

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