Individual
REBECCA D MATTINGLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC, LCAS
Contact information
Practice address
4000 WAKE FOREST RD STE 200, RALEIGH, NC 27609-6859
(919) 865-8710
Mailing address
4000 WAKE FOREST RD STE 200, RALEIGH, NC 27609-6859
(919) 865-8710
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LCAS-3256
NC
101YP2500X
Professional Counselor
Primary
10421
NC
Other
Enumeration date
10/31/2012
Last updated
10/03/2018
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