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NPI Code Detail

MEDICARE: MRS. REBECCA AUTRY

MEDICARE: MRS. REBECCA AUTRY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1760354278
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. REBECCA AUTRY
Provider Business Mailing Address
First Line : 2901 MARCUS JAMES DR
Second Line :
City : FAYETTEVILLE
State : NC
Zip : 28306-4609
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 900 N CHESTNUT ST
Second Line :
City : LUMBERTON
State : NC
Zip : 28358-4854
Country : US
Telephone Number : 910-739-3064
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/23/2025
Last Update Date : 09/23/2025

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Directions to “ MRS. REBECCA AUTRY ” Practice Location

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