Provider Demographics
NPI:1528577764
Name:BENTON, CHRISTA A'LAYNE (LPC, NCC)
Entity Type:Individual
Prefix:DR
First Name:CHRISTA
Middle Name:A'LAYNE
Last Name:BENTON
Suffix:
Gender:F
Credentials:LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 38188
Mailing Address - Street 2:
Mailing Address - City:HENRICO
Mailing Address - State:VA
Mailing Address - Zip Code:23231-0988
Mailing Address - Country:US
Mailing Address - Phone:804-208-0805
Mailing Address - Fax:804-441-8988
Practice Address - Street 1:1806 SUMMIT AVE STE 300
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23230-4339
Practice Address - Country:US
Practice Address - Phone:804-208-0805
Practice Address - Fax:804-441-8988
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-20
Last Update Date:2021-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701007284101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty