Provider Demographics
NPI:1619025020
Name:LOBA, PRISCILLA Z (LPCC)
Entity Type:Individual
Prefix:MS
First Name:PRISCILLA
Middle Name:Z
Last Name:LOBA
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:850 N 11TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMISBURG
Mailing Address - State:OH
Mailing Address - Zip Code:45342-1924
Mailing Address - Country:US
Mailing Address - Phone:937-866-6625
Mailing Address - Fax:937-866-7505
Practice Address - Street 1:850 N 11TH ST
Practice Address - Street 2:
Practice Address - City:MIAMISBURG
Practice Address - State:OH
Practice Address - Zip Code:45342-1924
Practice Address - Country:US
Practice Address - Phone:937-866-6625
Practice Address - Fax:937-866-7505
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE443101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY531789OtherPROVIDER NUMBER
OH000000345682Medicare UPIN