Provider Demographics
NPI:1699030080
Name:COCHRAN, SARAH GRACE (MSW, LISW)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:GRACE
Last Name:COCHRAN
Suffix:
Gender:F
Credentials:MSW, LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2821 WOODLAWN AVE NW
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44708-1423
Mailing Address - Country:US
Mailing Address - Phone:330-479-2378
Mailing Address - Fax:330-479-7456
Practice Address - Street 1:2821 WOODLAWN AVE NW
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44708-1423
Practice Address - Country:US
Practice Address - Phone:330-479-2378
Practice Address - Fax:330-479-7456
Is Sole Proprietor?:No
Enumeration Date:2012-07-11
Last Update Date:2018-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.18012111041C0700X
171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No171M00000XOther Service ProvidersCase Manager/Care Coordinator