Healthcare Provider Details

I. General information

NPI: 1942607387
Provider Name (Legal Business Name): CONNIE HOBBS LMHC, CAP, BC-TMH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/01/2014
Last Update Date: 05/03/2021
Certification Date: 05/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 BOSARVEY DR
ORMOND BEACH FL
32176-6625
US

IV. Provider business mailing address

210 BOSARVEY DR
ORMOND BEACH FL
32176-6625
US

V. Phone/Fax

Practice location:
  • Phone: 386-295-4420
  • Fax:
Mailing address:
  • Phone: 386-295-4420
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberADA-002758-2014
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberIMH11503
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number1080727
License Number StateFL
# 4
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH13572
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: