MEDICARE: ERIN E. COBB LISW-CP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	006440	SC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1689684441
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIN E. COBB LISW-CP

Provider Business Mailing Address
First Line	:	PO BOX 530062
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30353-0062
Country	:	US
Telephone Number	:	843-695-6071
Fax Number	:	843-569-5879

Provider Business Practice Location Address
First Line	:	2500 ELMS CENTER RD
Second Line	:
City	:	NORTH CHARLESTON
State	:	SC
Zip	:	29406-9844
Country	:	US
Telephone Number	:	843-572-7727
Fax Number	:	843-376-2706

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/08/2006
Last Update Date	:	07/06/2021

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