Healthcare Provider Details

I. General information

NPI: 1518788264
Provider Name (Legal Business Name): MORGAN A KOBITKA MSW, LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/24/2024
Last Update Date: 10/24/2024
Certification Date: 10/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1265 S LAKE PARK AVE STE B
HOBART IN
46342-5961
US

IV. Provider business mailing address

1265 S LAKE PARK AVE STE B
HOBART IN
46342-5961
US

V. Phone/Fax

Practice location:
  • Phone: 219-323-3311
  • Fax:
Mailing address:
  • Phone: 219-323-3311
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number33012468A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: