Provider Demographics
NPI:1285890152
Name:COBB, KAREN A (LPCC)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:A
Last Name:COBB
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:A
Other - Last Name:COBB
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMHC
Mailing Address - Street 1:8205 SPAIN ROAD NE
Mailing Address - Street 2:SUITE 106
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87109-3155
Mailing Address - Country:US
Mailing Address - Phone:505-384-7352
Mailing Address - Fax:808-271-9165
Practice Address - Street 1:6611 GULTON CT NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109-4407
Practice Address - Country:US
Practice Address - Phone:505-296-3965
Practice Address - Fax:505-323-9430
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-31
Last Update Date:2015-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0115531101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMLPCC 0160651OtherLICENSURE
NMM1919Medicaid
NM45303339Medicaid