Provider Demographics
NPI:1780439026
Name:YARBOROUGH, BENJAMIN (LCMHCA)
Entity type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:
Last Name:YARBOROUGH
Suffix:
Gender:M
Credentials:LCMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1504 FONT HILLS LN
Mailing Address - Street 2:
Mailing Address - City:KNIGHTDALE
Mailing Address - State:NC
Mailing Address - Zip Code:27545-8180
Mailing Address - Country:US
Mailing Address - Phone:252-414-5080
Mailing Address - Fax:
Practice Address - Street 1:500 E DAVIE ST STE 140
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27601-2093
Practice Address - Country:US
Practice Address - Phone:252-414-5080
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-19
Last Update Date:2024-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health