Healthcare Provider Details

I. General information

NPI: 1467416065
Provider Name (Legal Business Name): MICHAEL A COBLER LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 04/12/2006
Last Update Date: 10/13/2025
Certification Date: 10/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

109 CARROL DR
FRIES VA
24330-4532
US

IV. Provider business mailing address

3545 CARROLLTON PIKE
WOODLAWN VA
24381-3651
US

V. Phone/Fax

Practice location:
  • Phone: 888-908-4788
  • Fax: 276-398-3331
Mailing address:
  • Phone: 276-728-9184
  • Fax: 276-238-1766

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0701003260
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number0701003260
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: