Active NPI
Raymond Carr Benton Jr.
- Mental Health Counselor
- Greensboro, NC
National Provider Identifier
1306501424
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- A19716
- Practice address
- 3656 McConnell Rd Apt 2a
Greensboro, NC 27405-9784 - Phone
- (336) 962-1220
- NPI assigned
- Nov 3, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | |||
| Mental Health Counselor | 101YM0800X | A19716 | NC | Primary |
Addresses
Primary practice location
3656 McConnell Rd Apt 2a
Greensboro, NC 27405-9784
Mailing address
PO Box 3541
Greensboro, NC 27402-3541
Phone (336) 962-1220
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A19716 | NC | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1635897600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1718150400000",
"number": "1306501424",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3541",
"city": "GREENSBORO",
"state": "NC",
"postal_code": "274023541",
"telephone_number": "336-962-1220"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3656 MCCONNELL RD APT 2A",
"city": "GREENSBORO",
"state": "NC",
"postal_code": "274059784",
"telephone_number": "336-962-1220"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BENTON",
"first_name": "RAYMOND",
"middle_name": "CARR",
"name_suffix": "Jr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-11-03",
"last_updated": "2024-06-12",
"certification_date": "2024-06-12",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NC",
"license": "A19716",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Greensboro, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.