Provider Demographics
NPI:1003869314
Name:CODD, RICHARD TRENT III (EDS)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:TRENT
Last Name:CODD
Suffix:III
Gender:M
Credentials:EDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1085 TUNNEL RD STE 7A
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28805-2039
Mailing Address - Country:US
Mailing Address - Phone:828-350-1177
Mailing Address - Fax:828-350-1188
Practice Address - Street 1:1085 TUNNEL RD STE 7A
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28805-2039
Practice Address - Country:US
Practice Address - Phone:828-350-1177
Practice Address - Fax:828-350-1188
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2019-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC911101YA0400X
NC3745101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC12929OtherNC BC/BS PROVIDER NUMBER