Provider Demographics
NPI:1265690051
Name:COCHRAN, BONNIE C (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:BONNIE
Middle Name:C
Last Name:COCHRAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 S MELDRUM ST
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80521-2603
Mailing Address - Country:US
Mailing Address - Phone:970-222-1517
Mailing Address - Fax:970-484-3494
Practice Address - Street 1:205 S MELDRUM ST
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80521-2603
Practice Address - Country:US
Practice Address - Phone:970-222-1517
Practice Address - Fax:970-484-3494
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-28
Last Update Date:2008-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO4621041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical