Provider Demographics
NPI:1881042679
Name:JONES, BENJAMIN (MA, NCLPCA)
Entity Type:Individual
Prefix:MR
First Name:BENJAMIN
Middle Name:
Last Name:JONES
Suffix:
Gender:M
Credentials:MA, NCLPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7615 COLONY ROAD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28226-0007
Mailing Address - Country:US
Mailing Address - Phone:704-365-4545
Mailing Address - Fax:888-723-9330
Practice Address - Street 1:7615 COLONY RD
Practice Address - Street 2:SUITE 200
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28226-5017
Practice Address - Country:US
Practice Address - Phone:704-365-4545
Practice Address - Fax:888-723-9330
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-02
Last Update Date:2016-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA11895101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional