Healthcare Provider Details

I. General information

NPI: 1528731783
Provider Name (Legal Business Name): ROBIN LEE COCHRANE-CRANE LCSW, CADC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/26/2021
Last Update Date: 08/28/2024
Certification Date: 08/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 COMMERCE DR
SKOWHEGAN ME
04976-4823
US

IV. Provider business mailing address

5 COMMERCE DR
SKOWHEGAN ME
04976-4823
US

V. Phone/Fax

Practice location:
  • Phone: 207-474-8368
  • Fax: 207-612-3054
Mailing address:
  • Phone: 207-474-8368
  • Fax: 207-612-3054

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberMC20219
License Number StateME
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLC22916
License Number StateME
# 3
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCAC7724
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: