Individual provider Active NPI

Joann Cobb, LICSW

  • Clinical Social Worker
  • Manchester, NH
National Provider Identifier
1790875821
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
631 Issued in NH
Practice address
99 Hanover St
Manchester, NH 03101-2203
Phone
(603) 668-1920
Fax
(603) 668-6260
NPI assigned
Oct 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 631 NH Primary

Addresses

Primary practice location

99 Hanover St
Manchester, NH 03101-2203

Mailing address

99 Hanover Street
Manchester, NH 03103
Phone (603) 668-1920

Other identifiers 1

IdentifierTypeStateIssuer
80004065MedicaidNH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260519002860 FL Practitioner - Clinical Social Worker 0547739591 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1992
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3450 Ocean Beach Blvd
Apt 603
Cocoa Beach, FL 32931-5430

535 Mack Ave
Kingsley, MI 49649-9220

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
631NHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Child and Family Services Past Accepting new patients
Waypoint Clinical Past Accepting new patients
Child and Family Services Past Accepting new patients

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1790875821",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "99 HANOVER STREET",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "03103",
            "telephone_number": "603-668-1920",
            "fax_number": "603-668-6260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "99 HANOVER ST",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031012203",
            "telephone_number": "603-668-1920",
            "fax_number": "603-668-6260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COBB",
        "first_name": "JOANN",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-12",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NH",
            "license": "631",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "80004065",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, NH

Sources for this page

Verify at the official NPI Registry.