Provider Demographics
NPI:1265854012
Name:COBB, JOSEPH DUSTIN (LMSW)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:DUSTIN
Last Name:COBB
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4220 HERSCHEL AVE
Mailing Address - Street 2:#712
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75219-2359
Mailing Address - Country:US
Mailing Address - Phone:662-316-3613
Mailing Address - Fax:
Practice Address - Street 1:4054 MCKINNEY AVE
Practice Address - Street 2:#102
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75204-8212
Practice Address - Country:US
Practice Address - Phone:214-520-6308
Practice Address - Fax:214-521-9172
Is Sole Proprietor?:No
Enumeration Date:2014-01-14
Last Update Date:2014-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX57589104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker