Provider Demographics
NPI:1477705655
Name:BENBOW, LA'NEIKA (LCSW, MFT)
Entity Type:Individual
Prefix:MS
First Name:LA'NEIKA
Middle Name:
Last Name:BENBOW
Suffix:
Gender:F
Credentials:LCSW, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 1133
Mailing Address - Street 2:
Mailing Address - City:WINTERVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28590-1133
Mailing Address - Country:US
Mailing Address - Phone:252-493-6300
Mailing Address - Fax:252-493-6300
Practice Address - Street 1:235 COMMERCE ST
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27858-9939
Practice Address - Country:US
Practice Address - Phone:252-493-6300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-19
Last Update Date:2018-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0791481041C0700X
NCC0076761041C0700X
NY065393104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker