Healthcare Provider Details

I. General information

NPI: 1336053727
Provider Name (Legal Business Name): RHETT OWENSBY MA,LCMHC,LCAS,CCS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/01/2026
Last Update Date: 10/01/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

470 LAKE CONCORD DR
CONCORD NC
28025
US

IV. Provider business mailing address

209 LAKE GEORGE DR
SHELBY NC
28152-6986
US

V. Phone/Fax

Practice location:
  • Phone: 704-601-7653
  • Fax:
Mailing address:
  • Phone: 828-289-2071
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberLCAS-26909
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLCMHC-16477
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: