Provider Demographics
NPI:1649323080
Name:COBB, ARTEIA RENEA (MS, LCAS, LPC)
Entity type:Individual
Prefix:MS
First Name:ARTEIA
Middle Name:RENEA
Last Name:COBB
Suffix:
Gender:F
Credentials:MS, LCAS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2805 SKYBROOK LN
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27703-5976
Mailing Address - Country:US
Mailing Address - Phone:919-824-8756
Mailing Address - Fax:866-630-3244
Practice Address - Street 1:3308 DURHAM CHAPEL HILL BLVD STE 130
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27707-6233
Practice Address - Country:US
Practice Address - Phone:919-682-6715
Practice Address - Fax:866-630-3244
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-19
Last Update Date:2018-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1247101YA0400X
NC13713101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6112033Medicaid