Provider Demographics
NPI:1942459250
Name:COSBY, DANNY LEE (CAP/SAP)
Entity Type:Individual
Prefix:MR
First Name:DANNY
Middle Name:LEE
Last Name:COSBY
Suffix:
Gender:M
Credentials:CAP/SAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6919 GRAY OAK PL
Mailing Address - Street 2:
Mailing Address - City:RIVERVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:33578-4599
Mailing Address - Country:US
Mailing Address - Phone:813-690-7238
Mailing Address - Fax:813-672-0375
Practice Address - Street 1:6919 GRAY OAK PL
Practice Address - Street 2:
Practice Address - City:RIVERVIEW
Practice Address - State:FL
Practice Address - Zip Code:33578-4599
Practice Address - Country:US
Practice Address - Phone:813-690-7238
Practice Address - Fax:813-672-0375
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-10
Last Update Date:2009-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCAP-2655101YA0400X
FLSAP - 13142101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)