Provider Demographics
NPI:1972670487
Name:COCHRAN, JOYCE LEE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:JOYCE
Middle Name:LEE
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 1:32175 UPPER NESTUCCA RIVER RD
Mailing Address - Street 2:PO BOX 114
Mailing Address - City:BEAVER
Mailing Address - State:OR
Mailing Address - Zip Code:97108-9714
Mailing Address - Country:US
Mailing Address - Phone:503-398-5631
Mailing Address - Fax:503-398-5631
Practice Address - Street 1:32175 UPPER NESTUCCA RIVER RD
Practice Address - Street 2:
Practice Address - City:BEAVER
Practice Address - State:OR
Practice Address - Zip Code:97108-9714
Practice Address - Country:US
Practice Address - Phone:503-398-5631
Practice Address - Fax:503-398-5631
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORL001877101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health