Provider Demographics
NPI:1821685397
Name:KRISTY COBILLAS LPC LLC
Entity Type:Organization
Organization Name:KRISTY COBILLAS LPC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KRISTY
Authorized Official - Middle Name:
Authorized Official - Last Name:COBILLAS
Authorized Official - Suffix:
Authorized Official - Credentials:MED, LPC
Authorized Official - Phone:314-239-9686
Mailing Address - Street 1:7214 WILLOW LN
Mailing Address - Street 2:
Mailing Address - City:HAZELWOOD
Mailing Address - State:MO
Mailing Address - Zip Code:63042-2031
Mailing Address - Country:US
Mailing Address - Phone:314-239-9686
Mailing Address - Fax:314-735-4536
Practice Address - Street 1:7214 WILLOW LN
Practice Address - Street 2:
Practice Address - City:HAZELWOOD
Practice Address - State:MO
Practice Address - Zip Code:63042-2031
Practice Address - Country:US
Practice Address - Phone:314-239-9686
Practice Address - Fax:314-735-4536
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-30
Last Update Date:2020-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty