Healthcare Provider Details

I. General information

NPI: 1861409468
Provider Name (Legal Business Name): CATHERINE L. COCKEY PMHCNS-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2006
Last Update Date: 03/24/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2336 GODDARD PKWY
SALISBURY MD
21801-1126
US

IV. Provider business mailing address

2336 GODDARD PKWY
SALISBURY MD
21801-1126
US

V. Phone/Fax

Practice location:
  • Phone: 410-334-6961
  • Fax: 410-334-6362
Mailing address:
  • Phone: 410-334-6961
  • Fax: 410-334-6362

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberR068008
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License NumberR068008
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: