Willard J Cobb Jr., MACC, LMFTA, LPCA

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

12369 Issued in NC

Practice address

1801 E 5TH St
Suite 110
Charlotte, NC 28204-2379

Phone

(704) 375-5354

NPI assigned

Aug 19, 2016

Sex

Male

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

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

Specialty

Mental Health Counselor

Education

Other, 2015

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Sanctuary Counseling Group

  • Mental Health Counselor
  • Charlotte, NC
  • NPI 1386785251
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1471564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774396800000",
    "number": "1396290359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2129 E 7TH ST",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282043337",
            "telephone_number": "704-375-5354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 E 5TH ST",
            "address_2": "SUITE 110",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282042379",
            "telephone_number": "704-375-5354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COBB",
        "first_name": "WILLARD",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "MACC, LMFTA, LPCA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-08-19",
        "last_updated": "2026-03-25",
        "certification_date": "2026-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "12369",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Breanna Danielle Cobb
• Jennifer Cobb, LCMHCA
• Nikki Carrera Cobb, ARNP
• Shayla Courtney Cobb, PMHNP-BC
• Tiffany Faith Cobb, AGACNP-BC
• Daniel Alexander Cobbins
• James Cobbs
• Jamica Cobbs, MSW, LCSW
• Melissa Morgan Cobbs, PHD, LCMHCS, LCAS
• Jay Cobden

• 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 Mar 25, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.