Provider Demographics
NPI:1770225724
Name:COBB, LORI LYNN (MHC-LP)
Entity Type:Individual
Prefix:MS
First Name:LORI
Middle Name:LYNN
Last Name:COBB
Suffix:
Gender:F
Credentials:MHC-LP
Other - Prefix:MISS
Other - First Name:LORI
Other - Middle Name:LYNN
Other - Last Name:SCHELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:164 WACCAMW MED PARK DR
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:SC
Mailing Address - Zip Code:29526-8903
Mailing Address - Country:US
Mailing Address - Phone:843-347-5060
Mailing Address - Fax:843-347-3959
Practice Address - Street 1:184 COURT ST
Practice Address - Street 2:
Practice Address - City:BINGHAMTON
Practice Address - State:NY
Practice Address - Zip Code:13901-3515
Practice Address - Country:US
Practice Address - Phone:607-584-4465
Practice Address - Fax:607-584-4480
Is Sole Proprietor?:No
Enumeration Date:2022-04-11
Last Update Date:2022-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
NYP114223101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health