Provider Demographics
NPI:1679807291
Name:COSBY & COSBY COUNSELING & CONSULTATION LLC
Entity Type:Organization
Organization Name:COSBY & COSBY COUNSELING & CONSULTATION LLC
Other - Org Name:SOUTHERN COUNSELING GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:EMMA
Authorized Official - Middle Name:STACY
Authorized Official - Last Name:COSBY
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, PIP
Authorized Official - Phone:334-892-3252
Mailing Address - Street 1:614 W BYPASS
Mailing Address - Street 2:
Mailing Address - City:ANDALUSIA
Mailing Address - State:AL
Mailing Address - Zip Code:36420-4731
Mailing Address - Country:US
Mailing Address - Phone:334-222-3555
Mailing Address - Fax:
Practice Address - Street 1:614 W BYPASS
Practice Address - Street 2:
Practice Address - City:ANDALUSIA
Practice Address - State:AL
Practice Address - Zip Code:36420-4731
Practice Address - Country:US
Practice Address - Phone:334-582-2273
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-29
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL591103TC0700X
AL1384C1041C0700X
1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty