Provider Demographics
NPI:1144366394
Name:BENASUTTI, RAYMOND DAVID (MA)
Entity type:Individual
Prefix:
First Name:RAYMOND
Middle Name:DAVID
Last Name:BENASUTTI
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1536
Mailing Address - Street 2:
Mailing Address - City:MORGANTON
Mailing Address - State:NC
Mailing Address - Zip Code:28680-1536
Mailing Address - Country:US
Mailing Address - Phone:828-437-3000
Mailing Address - Fax:828-437-4999
Practice Address - Street 1:617 S GREEN ST
Practice Address - Street 2:SUITE 300
Practice Address - City:MORGANTON
Practice Address - State:NC
Practice Address - Zip Code:28655-3517
Practice Address - Country:US
Practice Address - Phone:828-437-3000
Practice Address - Fax:828-437-4999
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2014-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2162OtherLICENSE