Provider Demographics
NPI:1043710262
Name:HENCKEL, BENJAMIN THOMAS (LPC-MHSP)
Entity type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:THOMAS
Last Name:HENCKEL
Suffix:
Gender:M
Credentials:LPC-MHSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:681 MORGANTON SQUARE DR
Mailing Address - Street 2:
Mailing Address - City:MARYVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37801-4763
Mailing Address - Country:US
Mailing Address - Phone:865-297-3636
Mailing Address - Fax:
Practice Address - Street 1:10142 PARKSIDE DR STE 114
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37922-1955
Practice Address - Country:US
Practice Address - Phone:865-588-3173
Practice Address - Fax:615-369-8697
Is Sole Proprietor?:No
Enumeration Date:2018-02-14
Last Update Date:2025-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN7025101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional