MEDICARE: WHITNEY COBLE LPCA

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
1	101YP2500X	Professional Counselor	A11455	NC

General Provider Information

NPI Number	:	1487031696
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WHITNEY COBLE LPCA

Provider Business Mailing Address
First Line	:	2013 S ASHLAND DR
Second Line	:
City	:	BURLINGTON
State	:	NC
Zip	:	27217-1844
Country	:	US
Telephone Number	:	336-266-5489
Fax Number	:

Provider Business Practice Location Address
First Line	:	4415 MONROE RD
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28205-7754
Country	:	US
Telephone Number	:	704-332-3634
Fax Number	:	704-332-1801

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/27/2015
Last Update Date	:	04/27/2015

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