Healthcare Provider Details

I. General information

NPI: 1700676095
Provider Name (Legal Business Name): COCHRAN COUNSELING SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/09/2025
Last Update Date: 08/03/2025
Certification Date: 08/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

146 DEPOT ST STE 207
BLUE RIDGE GA
30513-8627
US

IV. Provider business mailing address

146 DEPOT ST STE 207
BLUE RIDGE GA
30513-8627
US

V. Phone/Fax

Practice location:
  • Phone: 678-235-5210
  • Fax:
Mailing address:
  • Phone: 678-235-5210
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DARLENA MICHELLE COCHRAN
Title or Position: OWNER
Credential: LPC
Phone: 678-235-5210