Provider Demographics
NPI:1740905538
Name:COBOS, ANA R (LCSW)
Entity type:Individual
Prefix:
First Name:ANA
Middle Name:R
Last Name:COBOS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 MARQUETTE AVE NW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87102-5340
Mailing Address - Country:US
Mailing Address - Phone:505-313-2941
Mailing Address - Fax:
Practice Address - Street 1:500 MARQUETTE AVE NW # 1241
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87102-5340
Practice Address - Country:US
Practice Address - Phone:505-313-2941
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-05
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMSWB-2022-08721041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical