Provider Demographics
NPI:1558088328
Name:DRAYTON, BENITA WHITE (LCMHC)
Entity type:Individual
Prefix:
First Name:BENITA
Middle Name:WHITE
Last Name:DRAYTON
Suffix:
Gender:F
Credentials:LCMHC
Other - Prefix:
Other - First Name:BENITA
Other - Middle Name:WHITE
Other - Last Name:CAMILO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCMHCA
Mailing Address - Street 1:5108 REAGAN DR STE 14
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28206-1395
Mailing Address - Country:US
Mailing Address - Phone:704-332-8787
Mailing Address - Fax:704-332-8788
Practice Address - Street 1:301 MCCULLOUGH DR STE 520
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28262-1336
Practice Address - Country:US
Practice Address - Phone:704-332-8787
Practice Address - Fax:704-332-8788
Is Sole Proprietor?:No
Enumeration Date:2022-10-24
Last Update Date:2025-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC18155101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional