Provider Demographics
NPI:1396939856
Name:NANETTE M. HOBACK, LCSW
Entity type:Organization
Organization Name:NANETTE M. HOBACK, LCSW
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FAMILY THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:NANETTE
Authorized Official - Middle Name:MARY
Authorized Official - Last Name:HOBACK
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:703-401-5875
Mailing Address - Street 1:13808 MIKEN COURT
Mailing Address - Street 2:
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20112-3743
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7502 DIPLOMAT DR.
Practice Address - Street 2:SUITE 101
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20109-2631
Practice Address - Country:US
Practice Address - Phone:703-401-5875
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-28
Last Update Date:2007-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040025861041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty