Provider Demographics
NPI:1467416065
Name:COBLER, MICHAEL A (LPC)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:A
Last Name:COBLER
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 1:3545 CARROLLTON PIKE
Mailing Address - Street 2:
Mailing Address - City:WOODLAWN
Mailing Address - State:VA
Mailing Address - Zip Code:24381-3651
Mailing Address - Country:US
Mailing Address - Phone:276-728-9184
Mailing Address - Fax:276-238-1766
Practice Address - Street 1:3545 CARROLLTON PIKE
Practice Address - Street 2:
Practice Address - City:WOODLAWN
Practice Address - State:VA
Practice Address - Zip Code:24381-3651
Practice Address - Country:US
Practice Address - Phone:276-728-9184
Practice Address - Fax:276-238-1766
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701003260101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA385274OtherANTHEM