Provider Demographics
NPI:1902198112
Name:MOTT, REBECCA LYNN (MSW, P-LCSW)
Entity Type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:LYNN
Last Name:MOTT
Suffix:
Gender:F
Credentials:MSW, P-LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:902 BONNER DR
Mailing Address - Street 2:
Mailing Address - City:JAMESTOWN
Mailing Address - State:NC
Mailing Address - Zip Code:27282-8948
Mailing Address - Country:US
Mailing Address - Phone:336-387-6161
Mailing Address - Fax:
Practice Address - Street 1:1250 SE MAYNARD RD STE 204
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27511-6947
Practice Address - Country:US
Practice Address - Phone:919-371-4378
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-05
Last Update Date:2022-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0051941041C0700X
NCC0090041041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical