Individual provider Active NPI

Kathryn Linette Cobb, MA LPC-S

  • Counselor
  • Clyde, TX
National Provider Identifier
1962691915
Registry record updated Aug 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
57645 Issued in TX
Practice address
1712 N Access Rd
Clyde, TX 79510-3352
Phone
(325) 893-4010
Fax
(325) 893-4042
NPI assigned
Oct 16, 2007
Last updated
Aug 2, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 57645 TX Primary
Professional Counselor 101YP2500X 57645 TX

Addresses

Primary practice location

1712 N Access Rd
Clyde, TX 79510-3352

Mailing address

1712 N Access Rd
Clyde, TX 79510-3352
Phone (325) 893-4010

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20240904002407 TX Practitioner - Mental Health Counselor 6507306636 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1712 N Access Rd
Clyde, TX 79510-3352
Phone (325) 893-4010

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
57645TXMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Shackelford County Community Resource Center CurrentSince Aug 1, 2024 Accepting new patients
Shackelford County Community Resource Center CurrentSince Aug 1, 2024 Accepting new patients
Carol Mapp and Associates Past Accepting new patients

Locations

725 Pate St
Albany, TX 76430
Phone (325) 762-2447

1712 N Access Rd
Clyde, TX 79510
Phone (325) 893-4010

Interoperability endpoints

  • Direct secure messaging: kathryn.cobb.1@28291.direct.athenahealth.com

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1192492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722556800000",
    "number": "1962691915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1712 N ACCESS RD",
            "city": "CLYDE",
            "state": "TX",
            "postal_code": "795103352",
            "telephone_number": "325-893-4010",
            "fax_number": "325-893-4042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1712 N ACCESS RD",
            "city": "CLYDE",
            "state": "TX",
            "postal_code": "795103352",
            "telephone_number": "325-893-4010",
            "fax_number": "325-893-4042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COBB",
        "first_name": "KATHRYN",
        "middle_name": "LINETTE",
        "name_prefix": "Mrs.",
        "credential": "MA LPC-S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-16",
        "last_updated": "2024-08-02",
        "certification_date": "2024-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "TX",
            "license": "57645",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "57645",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clyde, TX

Sources for this page

Verify at the official NPI Registry.