Provider Demographics
NPI:1285814194
Name:SUTTON, RENA O (MA, LPC, NCC, NBCT)
Entity type:Individual
Prefix:MS
First Name:RENA
Middle Name:O
Last Name:SUTTON
Suffix:
Gender:F
Credentials:MA, LPC, NCC, NBCT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:124 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:NC
Mailing Address - Zip Code:28734-2917
Mailing Address - Country:US
Mailing Address - Phone:828-342-6227
Mailing Address - Fax:
Practice Address - Street 1:124 W MAIN ST
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:NC
Practice Address - Zip Code:28734-2917
Practice Address - Country:US
Practice Address - Phone:828-342-6227
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-07
Last Update Date:2013-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6745101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6104208Medicaid