Provider Demographics
NPI:1093488488
Name:COBALT WELLNESS LLC
Entity Type:Organization
Organization Name:COBALT WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINICIAN
Authorized Official - Prefix:MR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:MATTHEW
Authorized Official - Last Name:WINSHIP
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:850-509-1181
Mailing Address - Street 1:224 E 6TH AVE
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32303-6208
Mailing Address - Country:US
Mailing Address - Phone:850-509-1181
Mailing Address - Fax:833-373-0728
Practice Address - Street 1:224 E 6TH AVE
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32303-6208
Practice Address - Country:US
Practice Address - Phone:850-509-1181
Practice Address - Fax:833-373-0728
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-30
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty