Provider Demographics
NPI:1396418414
Name:COBLE, PAUL IRVIN (LPC)
Entity Type:Individual
Prefix:MR
First Name:PAUL
Middle Name:IRVIN
Last Name:COBLE
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8221 WILLOW OAKS CORPORATE DR
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22031-4512
Mailing Address - Country:US
Mailing Address - Phone:703-207-7719
Mailing Address - Fax:
Practice Address - Street 1:2120 WASHINGTON BLVD
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22204-5718
Practice Address - Country:US
Practice Address - Phone:037-233-0929
Practice Address - Fax:703-228-5073
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-26
Last Update Date:2021-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701010619101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional