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General NPI Number Information
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NPI Number | 1902527385
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Entity Type | Individual
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Provider Name | BEVERLY L COBBS SUP-LCSW MSW MTS
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Gender | Female
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Dates
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Enumeration Date | 09/06/2022
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Last Update Date | 09/06/2022
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Provider Practice Location Address
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Address Line | 625 PINEY FOREST RD
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City | DANVILLE
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State | VA
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Zip | 24540-2867
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Country | US
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Telephone | 434-713-3340
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Fax |
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Provider Business Mailing Address
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Address Line | 806 N MAIN ST
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City | DANVILLE
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State | VA
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Zip | 24540-4440
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Country | US
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Telephone | 434-713-3340
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Fax |
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 0904009333
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 101YP1600X
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Taxonomy Name | Pastoral Counselor
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State | VA
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