Provider Demographics
NPI:1881455962
Name:COHILL, CEEAN LATRICE (LSW)
Entity type:Individual
Prefix:MS
First Name:CEEAN
Middle Name:LATRICE
Last Name:COHILL
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1336 CONNECTICUT ST
Mailing Address - Street 2:
Mailing Address - City:GARY
Mailing Address - State:IN
Mailing Address - Zip Code:46407-1330
Mailing Address - Country:US
Mailing Address - Phone:219-433-2805
Mailing Address - Fax:
Practice Address - Street 1:1336 CONNECTICUT ST STE R
Practice Address - Street 2:
Practice Address - City:GARY
Practice Address - State:IN
Practice Address - Zip Code:46407-1330
Practice Address - Country:US
Practice Address - Phone:219-433-2805
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-17
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN33009254A104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker