Provider Demographics
NPI:1811302730
Name:COBB, TRACY LEE (LPC)
Entity type:Individual
Prefix:
First Name:TRACY
Middle Name:LEE
Last Name:COBB
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4929
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80306-4929
Mailing Address - Country:US
Mailing Address - Phone:928-254-9153
Mailing Address - Fax:
Practice Address - Street 1:954 NORTH ST UNIT 204
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80304-3417
Practice Address - Country:US
Practice Address - Phone:720-708-7718
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-30
Last Update Date:2021-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health