Provider Demographics
NPI:1689118499
Name:GIENA COBB, PA.
Entity Type:Organization
Organization Name:GIENA COBB, PA.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GIENA
Authorized Official - Middle Name:
Authorized Official - Last Name:COBB
Authorized Official - Suffix:
Authorized Official - Credentials:PA, LMHC
Authorized Official - Phone:239-777-2613
Mailing Address - Street 1:PO BOX 110863
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34108-0115
Mailing Address - Country:US
Mailing Address - Phone:239-777-2613
Mailing Address - Fax:
Practice Address - Street 1:501 GOODLETTE RD N
Practice Address - Street 2:D-100
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34102-5661
Practice Address - Country:US
Practice Address - Phone:239-777-2613
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-13
Last Update Date:2016-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH8363101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty