Healthcare Provider Details

I. General information

NPI: 1720386949
Provider Name (Legal Business Name): HOBACK COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/11/2011
Last Update Date: 03/11/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

245 W JOHNSON RD
LA PORTE IN
46350-2026
US

IV. Provider business mailing address

245 W JOHNSON RD
LA PORTE IN
46350-2026
US

V. Phone/Fax

Practice location:
  • Phone: 219-369-4870
  • Fax:
Mailing address:
  • Phone: 219-369-4870
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: NANCY HOBACK
Title or Position: OWNER
Credential:
Phone: 219-369-4870