Healthcare Provider Details

I. General information

NPI: 1285542100
Provider Name (Legal Business Name): MICHAEL COBB
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19 LAMBSON LN STE B102
NEW CASTLE DE
19720-2118
US

IV. Provider business mailing address

247 JORDAN DR
DOVER DE
19904-2004
US

V. Phone/Fax

Practice location:
  • Phone: 302-510-6706
  • Fax:
Mailing address:
  • Phone: 610-888-0076
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: