Provider Demographics
NPI:1881899482
Name:COCHRAN, BETTINA RENEE (LMSW)
Entity type:Individual
Prefix:
First Name:BETTINA
Middle Name:RENEE
Last Name:COCHRAN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1601 ARKANSAS AVE
Mailing Address - Street 2:
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76541-8268
Mailing Address - Country:US
Mailing Address - Phone:254-690-5152
Mailing Address - Fax:
Practice Address - Street 1:1601 ARKANSAS AVE
Practice Address - Street 2:
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76541-8268
Practice Address - Country:US
Practice Address - Phone:254-415-8971
Practice Address - Fax:361-727-2036
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-15
Last Update Date:2016-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX40977104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker