MEDICARE: CYNTHIA M COCHRAN LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	2022036829	MO
2	1041C0700X	Clinical Social Worker	8409	TN
3	1041C0700X	Clinical Social Worker	SW12768	FL
4	1041C0700X	Clinical Social Worker	CSW09929962	CO
5	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1740488873
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CYNTHIA M COCHRAN LCSW

Provider Business Mailing Address
First Line	:	1107 3RD ST SW STE 9
Second Line	:
City	:	WINTER HAVEN
State	:	FL
Zip	:	33880-3912
Country	:	US
Telephone Number	:	863-292-6089
Fax Number	:

Provider Business Practice Location Address
First Line	:	1107 3RD ST SW STE 9
Second Line	:
City	:	WINTER HAVEN
State	:	FL
Zip	:	33880-3912
Country	:	US
Telephone Number	:	863-292-6089
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/10/2007
Last Update Date	:	02/16/2024

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