Provider Demographics
NPI:1770069957
Name:COBB, LUCIA (MA,LPC,NCC,LCDC-I)
Entity type:Individual
Prefix:
First Name:LUCIA
Middle Name:
Last Name:COBB
Suffix:
Gender:F
Credentials:MA,LPC,NCC,LCDC-I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1609 DESERT CANDLE
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78245-3588
Mailing Address - Country:US
Mailing Address - Phone:210-722-3987
Mailing Address - Fax:
Practice Address - Street 1:6502 BANDERA RD STE 212
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78238-1454
Practice Address - Country:US
Practice Address - Phone:210-722-3987
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-11
Last Update Date:2024-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX76834101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional