Provider Demographics
NPI:1073777314
Name:COBB, BLAIR WINSLOW (MSW LCSW)
Entity Type:Individual
Prefix:MS
First Name:BLAIR
Middle Name:WINSLOW
Last Name:COBB
Suffix:
Gender:F
Credentials:MSW LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1048 STAMFORD CLUB DR.
Mailing Address - Street 2:
Mailing Address - City:RURAL HALL
Mailing Address - State:NC
Mailing Address - Zip Code:27312
Mailing Address - Country:US
Mailing Address - Phone:919-619-2232
Mailing Address - Fax:
Practice Address - Street 1:5 DUNDAS CIR STE B
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27407-1638
Practice Address - Country:US
Practice Address - Phone:336-299-6614
Practice Address - Fax:336-299-6615
Is Sole Proprietor?:No
Enumeration Date:2008-07-16
Last Update Date:2013-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0086021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical