Gary D. Cobb, PH.D., P.C.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

0810001673 Issued in VA

Legal business name

GARY D. COBB, PH.D., P.C.

Practice address

4001 Fair Ridge Dr
Suite 305
Fairfax, VA 22033-2917

Phone

(703) 883-4774

Fax

(703) 218-1824

NPI assigned

Jan 30, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Gary D. Cobb, PH.D.

Title

Clinical Psychologist

Phone

(703) 883-4774

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1391040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1391040000000",
    "number": "1780007450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4001 FAIR RIDGE DR",
            "address_2": "SUITE 305",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220332917",
            "telephone_number": "703-883-4774",
            "fax_number": "703-218-1824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4001 FAIR RIDGE DR",
            "address_2": "SUITE 305",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220332917",
            "telephone_number": "703-883-4774",
            "fax_number": "703-218-1824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GARY D. COBB, PH.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-30",
        "last_updated": "2014-01-30",
        "status": "A",
        "authorized_official_last_name": "COBB",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "703-883-4774",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810001673",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in Fairfax, VA
• Providers in Fairfax, VA by specialty
• Clinical Psychologist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2014; 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.