Provider Demographics
NPI:1093465288
Name:COBB, TAMIKA (LMSW)
Entity Type:Individual
Prefix:MS
First Name:TAMIKA
Middle Name:
Last Name:COBB
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:910 S CHAPEL ST STE 102
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19713-3468
Mailing Address - Country:US
Mailing Address - Phone:302-922-8261
Mailing Address - Fax:
Practice Address - Street 1:910 S CHAPEL ST STE 102
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713-3468
Practice Address - Country:US
Practice Address - Phone:302-224-1400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-28
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEQ3-0010721101Y00000X
DEQ300107211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101Y00000XBehavioral Health & Social Service ProvidersCounselor