Provider Demographics
NPI:1457483596
Name:HOBACK, NANCY (LCSW)
Entity Type:Individual
Prefix:MS
First Name:NANCY
Middle Name:
Last Name:HOBACK
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:245 W JOHNSON RD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:LA PORTE
Mailing Address - State:IN
Mailing Address - Zip Code:46350-2026
Mailing Address - Country:US
Mailing Address - Phone:219-369-4870
Mailing Address - Fax:219-369-4948
Practice Address - Street 1:245 W JOHNSON RD
Practice Address - Street 2:
Practice Address - City:LA PORTE
Practice Address - State:IN
Practice Address - Zip Code:46350-2026
Practice Address - Country:US
Practice Address - Phone:219-369-4870
Practice Address - Fax:219-369-4948
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-12
Last Update Date:2009-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34004167A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical