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General NPI Number Information
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NPI Number | 1043512098
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Entity Type | Individual
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Provider Name | NICHOLE M COBB LISW-S, OCPC
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Gender | Female
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Dates
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Enumeration Date | 11/24/2010
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Last Update Date | 08/02/2024
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Provider Practice Location Address
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Address Line | 33333 STATION ST UNIT 391006
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City | SOLON
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State | OH
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Zip | 44139-9533
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Country | US
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Telephone | 440-252-5354
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Fax | 440-252-5379
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Provider Business Mailing Address
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Address Line | 33333 STATION ST UNIT 391006
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City | SOLON
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State | OH
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Zip | 44139-9533
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Country | US
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Telephone | 440-252-5354
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Fax | 440-252-5379
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | I.0008675-SUPV
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License Number State | OH
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