MEDICARE: ALLISON COBAUGH LCSW

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	104100000X	Social Worker	28215907	PA

General Provider Information

NPI Number	:	1891054854
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALLISON COBAUGH LCSW

Provider Business Mailing Address
First Line	:	2626 NORTH THIRD STREET
Second Line	:
City	:	HARRISBURG
State	:	PA
Zip	:	17110-2044
Country	:	US
Telephone Number	:	717-232-5443
Fax Number	:	717-232-4553

Provider Business Practice Location Address
First Line	:	2626 NORTH THIRD STREET
Second Line	:
City	:	HARRISBURG
State	:	PA
Zip	:	17110-2044
Country	:	US
Telephone Number	:	717-232-5443
Fax Number	:	717-232-4553

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

Provider Enumeration Date	:	05/11/2012
Last Update Date	:	12/03/2020

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