Provider Demographics
NPI:1417661661
Name:LINVILLE, ANDREW COCHRAN (LCSW-A)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:COCHRAN
Last Name:LINVILLE
Suffix:
Gender:M
Credentials:LCSW-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4021 BELLA PARK TRL APT 335
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27613-7583
Mailing Address - Country:US
Mailing Address - Phone:865-978-0144
Mailing Address - Fax:
Practice Address - Street 1:4021 BELLA PARK TRL APT 335
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27613-7583
Practice Address - Country:US
Practice Address - Phone:865-978-0144
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-12
Last Update Date:2023-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0173261041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical