Provider Demographics
NPI:1013386861
Name:NANCY PAULK MOBLEY
Entity Type:Organization
Organization Name:NANCY PAULK MOBLEY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PROFESSIONAL COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:PAULK
Authorized Official - Last Name:MOBLEY
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:478-335-6948
Mailing Address - Street 1:584 ARLINGTON PL
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31201-1705
Mailing Address - Country:US
Mailing Address - Phone:478-743-1472
Mailing Address - Fax:478-743-1472
Practice Address - Street 1:584 ARLINGTON PL
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31201-1705
Practice Address - Country:US
Practice Address - Phone:478-743-1472
Practice Address - Fax:478-743-1472
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-23
Last Update Date:2015-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA003438103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Single Specialty