Individual provider Active NPI

Lisa Bentz, LCAS

  • Addiction (Substance Use Disorder) Counselor
  • Wilmington, NC
National Provider Identifier
1710124227
Registry record updated Nov 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
1358 Issued in NC
Practice address
201 N Front St Ste 713
Wilmington, NC 28401-5090
Phone
(910) 619-7500
NPI assigned
Jan 21, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 1358 NC Primary

Addresses

Primary practice location

201 N Front St Ste 713
Wilmington, NC 28401-5090

Mailing address

609A Piner Rd Ste 182
Wilmington, NC 28409-4201
Phone (910) 619-7500

Other identifiers 1

IdentifierTypeStateIssuer
6112068MedicaidNC

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

LicenseStateTypeSpecialty
1358NCMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1232496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605484800000",
    "number": "1710124227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "609A PINER RD STE 182",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284094201",
            "telephone_number": "910-619-7500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 N FRONT ST STE 713",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284015090",
            "telephone_number": "910-619-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENTZ",
        "first_name": "LISA",
        "name_prefix": "Mrs.",
        "credential": "LCAS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-21",
        "last_updated": "2020-11-16",
        "certification_date": "2020-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "1358",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6112068",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.