Provider Demographics
NPI:1033324033
Name:MAYES, REBECCA B (NBCC, LPC)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:B
Last Name:MAYES
Suffix:
Gender:F
Credentials:NBCC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 C C HAYES RD
Mailing Address - Street 2:
Mailing Address - City:PURLEAR
Mailing Address - State:NC
Mailing Address - Zip Code:28665-9173
Mailing Address - Country:US
Mailing Address - Phone:336-903-0261
Mailing Address - Fax:
Practice Address - Street 1:300 C C HAYES RD
Practice Address - Street 2:
Practice Address - City:PURLEAR
Practice Address - State:NC
Practice Address - Zip Code:28665-9173
Practice Address - Country:US
Practice Address - Phone:336-903-0261
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3457101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health