Provider Demographics
NPI:1346290517
Name:BENFIELD & PODGER ASSOCS., LTD
Entity Type:Organization
Organization Name:BENFIELD & PODGER ASSOCS., LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CRYSTAL
Authorized Official - Middle Name:
Authorized Official - Last Name:PODGER
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPC, CBIS-CI
Authorized Official - Phone:704-325-3181
Mailing Address - Street 1:PO BOX 278
Mailing Address - Street 2:
Mailing Address - City:CONOVER
Mailing Address - State:NC
Mailing Address - Zip Code:28613-0278
Mailing Address - Country:US
Mailing Address - Phone:704-325-3181
Mailing Address - Fax:704-325-3182
Practice Address - Street 1:3314 16TH AVE SE
Practice Address - Street 2:STE. 206
Practice Address - City:CONOVER
Practice Address - State:NC
Practice Address - Zip Code:28613-9694
Practice Address - Country:US
Practice Address - Phone:704-325-3181
Practice Address - Fax:704-325-3182
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-10
Last Update Date:2013-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2892101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC12581OtherBCBS
NC6102453Medicaid