T'Revah Cobb

Primary specialty

CounselorTaxonomy code 101Y00000X

Practice address

412 N Washington Ave
El Dorado, AR 71730-5616

Phone

(870) 863-4611

Fax

(870) 741-4784

NPI assigned

Aug 6, 2018

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• T'Revah Macon Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1533513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533513600000",
    "number": "1013495589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "412 N WASHINGTON AVE",
            "city": "EL DORADO",
            "state": "AR",
            "postal_code": "717305616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "412 N WASHINGTON AVE",
            "city": "EL DORADO",
            "state": "AR",
            "postal_code": "717305616",
            "telephone_number": "870-863-4611",
            "fax_number": "870-741-4784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COBB",
        "first_name": "T'REVAH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-06",
        "last_updated": "2018-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "T'REVAH",
            "last_name": "MACON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Christina Lynn Chudomelka, FNP-BC
• City of El Dorado Office of City Clerk
• Clements Family Dentistry
• Wanda F Clements, LPN
• Clinical Pathology Laboratory, LLC
• Lindsey Cole
• Rachel E Cole, MA, CF-SLP
• Jo Ellen Colvin, CCC-SLP
• Community Living Arrangements
• Compliance & Screening Services CSS

• All providers in El Dorado, AR
• Counselor in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.