Provider Demographics
NPI:1336827617
Name:RASCOE, CHRISTINA RACHELLE (MED, LCMHCA)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:RACHELLE
Last Name:RASCOE
Suffix:
Gender:F
Credentials:MED, LCMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7750 SUNFIELD CIR APT 205
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27617-6765
Mailing Address - Country:US
Mailing Address - Phone:919-630-3598
Mailing Address - Fax:
Practice Address - Street 1:3708 LYCKAN PKWY STE 106
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27707-2586
Practice Address - Country:US
Practice Address - Phone:919-514-3566
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-07
Last Update Date:2023-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA18870101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health