| Cobblestone Therapy | |
|
52582 State Road 933 South Bend IN 46637-3239 | |
| (256) 276-7000 | |
| Not Available |
| Full Name | Cobblestone Therapy |
|---|---|
| Speciality | Social Worker |
| Location | 52582 State Road 933, South Bend, Indiana |
| Authorized Official Name and Position | Elizabeth Cobb (OWNER) |
| Authorized Official Contact | 2562767000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cobblestone Therapy 52582 State Road 933 South Bend IN 46637-3239 Ph: (256) 276-7000 | Cobblestone Therapy 52582 State Road 933 South Bend IN 46637-3239 Ph: (256) 276-7000 |
| NPI Number | 1104660737 |
|---|---|
| Provider Enumeration Date | 06/19/2024 |
| Last Update Date | 07/29/2024 |
| Certification Date | 07/29/2024 |
| Medicare PECOS PAC ID | 6507390820 |
|---|---|
| Medicare Enrollment ID | O20241108003604 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104660737 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Elizabeth Cobb |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1861151896 PECOS PAC ID: 2567857550 Enrollment ID: I20220309001125 |
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