Provider Demographics
NPI:1740333400
Name:MOBLEY, KARIN M (LPCC, CDCA)
Entity type:Individual
Prefix:
First Name:KARIN
Middle Name:M
Last Name:MOBLEY
Suffix:
Gender:F
Credentials:LPCC, CDCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1925 HAYES AVE
Mailing Address - Street 2:
Mailing Address - City:SANDUSKY
Mailing Address - State:OH
Mailing Address - Zip Code:44870-4737
Mailing Address - Country:US
Mailing Address - Phone:419-557-5177
Mailing Address - Fax:
Practice Address - Street 1:76 ASHWOOD ROAD
Practice Address - Street 2:
Practice Address - City:TIFFIN
Practice Address - State:OH
Practice Address - Zip Code:44883-1908
Practice Address - Country:US
Practice Address - Phone:419-448-9440
Practice Address - Fax:419-448-5155
Is Sole Proprietor?:No
Enumeration Date:2007-01-18
Last Update Date:2020-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCDCA.011225101YP2500X
OHE.0007501101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional