Provider Demographics
NPI:1275531329
Name:LOBB, GREG A (PHD)
Entity Type:Individual
Prefix:MR
First Name:GREG
Middle Name:A
Last Name:LOBB
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 SOUTHERN AVENUE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15211
Mailing Address - Country:US
Mailing Address - Phone:412-431-0711
Mailing Address - Fax:412-431-0732
Practice Address - Street 1:160 SOUTHERN AVE.
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15211
Practice Address - Country:US
Practice Address - Phone:412-431-0711
Practice Address - Fax:412-431-0732
Is Sole Proprietor?:No
Enumeration Date:2005-07-12
Last Update Date:2010-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC003548101YM0800X
PAPS016807103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1014724840001Medicaid