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Individual
JOSETTA LAVONIA SUMTER-COBB
Active
Individual
JOSETTA LAVONIA SUMTER-COBB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LPC-I
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
5544
SC
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
5544
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
570569761
TAX ID
SC
05
—
AD01AK
—
SC
Enumeration date
11/16/2011
Last updated
10/02/2017
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