Bethani Cogburn, PHD, LCMHC, QS

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

13192 Issued in NC

Practice address

1235 East Blvd
Ste E #176
Charlotte, NC 28203-5876

Phone

(704) 266-2087

NPI assigned

Jun 11, 2020

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Cogburn Counseling & Supervision PLLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Charlotte, NC
  • NPI 1043198583
  NPD Authorized official
• Clear Vista Counseling PLLC

  • Mental Health Counselor
  • Charlotte, NC
  • NPI 1396368767
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1591833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755388800000",
    "number": "1053936336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1235 EAST BLVD.",
            "address_2": "STE E #176",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282035876",
            "telephone_number": "704-266-2087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1235 EAST BLVD",
            "address_2": "STE E #176",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282035876",
            "telephone_number": "704-266-2087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COGBURN",
        "first_name": "BETHANI",
        "name_prefix": "Dr.",
        "credential": "PHD, LCMHC, QS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-11",
        "last_updated": "2025-08-17",
        "certification_date": "2025-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "13192",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abelard Kpkpo Cofie, MD
• Ashley Cofield
• Harvis Cofield
• Tamia Michelle Cofield, PT,DPT
• Cogburn Counseling & Supervision PLLC
• Tammy Dockery Cogdill, ANP
• Shannon Cogen, PUBLIC HEALTH RDH
• Jordan Blair Huffman Coggin
• Melissa Yeung Coggin, FNP-C
• Benjamin L Coggins, CADC

• Mental Health Counselor in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Mental Health Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.