Provider Demographics
NPI:1306884564
Name:BENSON, DAVID LAWTON (LCSW)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:LAWTON
Last Name:BENSON
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4520 PICKNEY CT
Mailing Address - Street 2:
Mailing Address - City:KERNERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27284-7131
Mailing Address - Country:US
Mailing Address - Phone:336-986-8553
Mailing Address - Fax:
Practice Address - Street 1:125 ALLEN ST
Practice Address - Street 2:
Practice Address - City:KERNERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:27284
Practice Address - Country:US
Practice Address - Phone:336-293-7406
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-02
Last Update Date:2020-02-11
Deactivation Date:2007-04-16
Deactivation Code:
Reactivation Date:2015-10-14
Provider Licenses
StateLicense IDTaxonomies
NCC0026871041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical