Provider Demographics
NPI:1568167948
Name:COCKERHAM, MORIAH (LCMHCA)
Entity Type:Individual
Prefix:
First Name:MORIAH
Middle Name:
Last Name:COCKERHAM
Suffix:
Gender:F
Credentials:LCMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10700 SIKES PL STE 325
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28277-8208
Mailing Address - Country:US
Mailing Address - Phone:704-247-7353
Mailing Address - Fax:704-912-1614
Practice Address - Street 1:10700 SIKES PL STE 325
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28277-8208
Practice Address - Country:US
Practice Address - Phone:704-247-7353
Practice Address - Fax:704-912-1614
Is Sole Proprietor?:No
Enumeration Date:2023-04-04
Last Update Date:2023-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA18540101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional