Provider Demographics
NPI:1063797132
Name:WEBB, ODYESSEY (LPCA)
Entity type:Individual
Prefix:
First Name:ODYESSEY
Middle Name:
Last Name:WEBB
Suffix:
Gender:F
Credentials:LPCA
Other - Prefix:
Other - First Name:ODYESSEY
Other - Middle Name:
Other - Last Name:SIMMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCMHCS, LCAS-A, LPC
Mailing Address - Street 1:946 PECAN GROVE LOOP
Mailing Address - Street 2:
Mailing Address - City:HOPE MILLS
Mailing Address - State:NC
Mailing Address - Zip Code:28348-8147
Mailing Address - Country:US
Mailing Address - Phone:917-569-8752
Mailing Address - Fax:877-552-1863
Practice Address - Street 1:946 PECAN GROVE LOOP
Practice Address - Street 2:
Practice Address - City:HOPE MILLS
Practice Address - State:NC
Practice Address - Zip Code:28348-8147
Practice Address - Country:US
Practice Address - Phone:917-569-8752
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-20
Last Update Date:2025-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
NC3431-A101YA0400X
NC8991101YP2500X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional