Individual provider Active NPI

Rebecca D Mattingly, LPC, LCAS

  • Professional Counselor
  • Raleigh, NC
National Provider Identifier
1154675031
Registry record updated Oct 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
10421 Issued in NC
Practice address
4000 Wake Forest Rd Ste 200
Raleigh, NC 27609-6859
Phone
(919) 865-8710
NPI assigned
Oct 31, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X LCAS-3256 NC
Professional Counselor 101YP2500X 10421 NC Primary

Addresses

Primary practice location

4000 Wake Forest Rd Ste 200
Raleigh, NC 27609-6859

Mailing address

4000 Wake Forest Rd Ste 200
Raleigh, NC 27609-6859
Phone (919) 865-8710

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240105003466 NC Practitioner - Mental Health Counselor 9931550787 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
MonarchGroup PAC ID 0244273852, 92 clinicians

Practice addresses (Care Compare)

350 Pee Dee Ave
Suite 101
Albemarle, NC 28001-4945
Phone (704) 986-1500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCAS-3256NCMDAddiction (Substance Use Disorder) Counselor
10421NCMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Monarch CurrentSince Jan 1, 2024 Accepting new patients
Monarch CurrentSince Jan 1, 2024 Accepting new patients
Monarch Current Accepting new patients

Locations

350 Pee Dee Ave
Ste 101
Albemarle, NC 28001
Phone (704) 986-1522

820 Grimes Blvd
Lexington, NC 27292
Phone (336) 224-6071

319 Chapanoke Rd
Ste 119
Raleigh, NC 27603

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1351641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538524800000",
    "number": "1154675031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 WAKE FOREST RD STE 200",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276096859",
            "telephone_number": "919-865-8710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 WAKE FOREST RD STE 200",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276096859",
            "telephone_number": "919-865-8710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTINGLY",
        "first_name": "REBECCA",
        "middle_name": "D",
        "credential": "LPC, LCAS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-31",
        "last_updated": "2018-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "LCAS-3256",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "10421",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.