Provider Demographics
NPI:1760190714
Name:COCHRAN, CATHERINE (LICSW)
Entity Type:Individual
Prefix:MS
First Name:CATHERINE
Middle Name:
Last Name:COCHRAN
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 DICKINSON AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02904-3631
Mailing Address - Country:US
Mailing Address - Phone:401-617-1904
Mailing Address - Fax:
Practice Address - Street 1:1992 OLD LOUISQUISSET PIKE
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:RI
Practice Address - Zip Code:02865-4590
Practice Address - Country:US
Practice Address - Phone:401-617-1904
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-08
Last Update Date:2022-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIISW036971041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty