Organization Active NPI

Cobblestone Therapy

  • Clinical Social Worker
  • South Bend, IN
National Provider Identifier
1104660737
Registry record updated Jul 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
COBBLESTONE THERAPY
Practice address
52582 State Road 933
South Bend, IN 46637-3239
Phone
(256) 276-7000
NPI assigned
Jun 19, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2024

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

Authorized official

Name
Elizabeth CobbNPI 1861151896
Title
Owner
Phone
(256) 276-7000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

52582 State Road 933
South Bend, IN 46637-3239

Mailing address

52582 State Road 933
South Bend, IN 46637-3239
Phone (256) 276-7000

Other names 1

  • Elizabeth Cobb Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241108003604 IN Part B Supplier - Clinic/Group Practice 6507390820 Receives reassigned benefits from 1 practitioner
Practice locations: South Bend, IN

National Provider Directory

National Provider Directory

Locations

52582 State Road 933
South Bend, IN 46637
Phone (256) 276-7000

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1718755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722211200000",
    "number": "1104660737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "52582 STATE ROAD 933",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466373239",
            "telephone_number": "256-276-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "52582 STATE ROAD 933",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466373239",
            "telephone_number": "256-276-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COBBLESTONE THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-19",
        "last_updated": "2024-07-29",
        "certification_date": "2024-07-29",
        "status": "A",
        "authorized_official_last_name": "COBB",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "256-276-7000"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Elizabeth Cobb",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in South Bend, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.