Provider Demographics
NPI:1487442067
Name:BEN, CARNESHA (MRC, LPC)
Entity type:Individual
Prefix:
First Name:CARNESHA
Middle Name:
Last Name:BEN
Suffix:
Gender:F
Credentials:MRC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1504 KATHLEEN ST APT 3503
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:AR
Mailing Address - Zip Code:72401-9431
Mailing Address - Country:US
Mailing Address - Phone:870-680-2674
Mailing Address - Fax:
Practice Address - Street 1:1504 KATHLEEN ST APT 3503
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:AR
Practice Address - Zip Code:72401-9431
Practice Address - Country:US
Practice Address - Phone:870-680-2674
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-25
Last Update Date:2025-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARP2203003101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health