Provider Demographics
NPI:1568643344
Name:COBB, LOREN MICHELLE (MFTI)
Entity Type:Individual
Prefix:MS
First Name:LOREN
Middle Name:MICHELLE
Last Name:COBB
Suffix:
Gender:F
Credentials:MFTI
Other - Prefix:MS
Other - First Name:LOREN
Other - Middle Name:FELDMAN
Other - Last Name:COBB
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MFTI
Mailing Address - Street 1:3420 PUMP RD
Mailing Address - Street 2:#213
Mailing Address - City:HENRICO
Mailing Address - State:VA
Mailing Address - Zip Code:23233-1111
Mailing Address - Country:US
Mailing Address - Phone:804-370-5989
Mailing Address - Fax:
Practice Address - Street 1:501 E FRANKLIN ST
Practice Address - Street 2:SUITE 414
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23219-2322
Practice Address - Country:US
Practice Address - Phone:804-370-5989
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-20
Last Update Date:2014-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0717001311106H00000X
CAMFT49671106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist