Provider Demographics
NPI:1942607387
Name:HOBBS, CONNIE (LMHC, CAP, BC-TMH)
Entity Type:Individual
Prefix:
First Name:CONNIE
Middle Name:
Last Name:HOBBS
Suffix:
Gender:F
Credentials:LMHC, CAP, BC-TMH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 BOSARVEY DR
Mailing Address - Street 2:
Mailing Address - City:ORMOND BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32176-6625
Mailing Address - Country:US
Mailing Address - Phone:386-295-4420
Mailing Address - Fax:
Practice Address - Street 1:210 BOSARVEY DR
Practice Address - Street 2:
Practice Address - City:ORMOND BEACH
Practice Address - State:FL
Practice Address - Zip Code:32176-6625
Practice Address - Country:US
Practice Address - Phone:386-295-4420
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-01
Last Update Date:2021-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLADA-002758-2014101YA0400X
FLIMH11503101YM0800X
FL1080727101YS0200X
FLMH13572101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool