Provider Demographics
NPI:1023288271
Name:HUTCHINSON, BENITA JO (LMSW)
Entity type:Individual
Prefix:MS
First Name:BENITA
Middle Name:JO
Last Name:HUTCHINSON
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1117 HOLMES AVE
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:NC
Mailing Address - Zip Code:28144-2614
Mailing Address - Country:US
Mailing Address - Phone:136-246-6543
Mailing Address - Fax:313-631-0168
Practice Address - Street 1:300 N SALISBURY AVE
Practice Address - Street 2:
Practice Address - City:SPENCER
Practice Address - State:NC
Practice Address - Zip Code:28159-2514
Practice Address - Country:US
Practice Address - Phone:704-216-2630
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-04
Last Update Date:2024-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010853061041C0700X
NCC0135201041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1705289Medicaid
MI5266701OtherAETNA BEHAVIORAL HEALTH
MI7509104190OtherBCBSM MENTAL HEALTH PIN
MI20530OtherBCBSM SUBSTANC ABUSE PIN
MI258694OtherMHN PIN
MI0911419OtherBCBSM MESSA/MAGELLAN
MI1063603106OtherHEALTH PLUS PIN
MI028363OtherVALUE OPTIONS
MI130958OtherCARE CHOICES & PREFERRED
MI1705289Medicaid