Provider Demographics
NPI:1154707420
Name:COX, RACHEL STAUTY (MA, LPC, LCAS, CCS-I)
Entity type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:STAUTY
Last Name:COX
Suffix:
Gender:F
Credentials:MA, LPC, LCAS, CCS-I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6014 LB HILL FARM RD
Mailing Address - Street 2:
Mailing Address - City:GRIFTON
Mailing Address - State:NC
Mailing Address - Zip Code:28530-8106
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2902 N HERRITAGE ST STE A
Practice Address - Street 2:
Practice Address - City:KINSTON
Practice Address - State:NC
Practice Address - Zip Code:28501-1580
Practice Address - Country:US
Practice Address - Phone:252-916-7532
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-10
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC21683101YA0400X
NC20965101YA0400X
NC12626101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC12626OtherNORTH CAROLINA BOARD OF LICENSED PROFESSIONAL COUNSELORSLICENSED PROFESSIONAL
NC20965OtherNORTH CAROLINA SUBSTANCE ABUSE PROFESSIONAL PRACTICE BOARD
NC21683OtherNORTH CAROLINA SUBSTANCE ABUSE PROFESSIONAL PRACTICE BOARD