Healthcare Provider Details

I. General information

NPI: 1710077326
Provider Name (Legal Business Name): CINDY BROWN COCKRELL LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/13/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

127 WEST SOUTH MAIN ST UNIT #5
LITTLETON NC
27850-9822
US

IV. Provider business mailing address

127 WEST SOUTH MAIN ST UNIT #5
LITTLETON NC
27850-9822
US

V. Phone/Fax

Practice location:
  • Phone: 252-586-2160
  • Fax: 252-586-6720
Mailing address:
  • Phone: 252-586-2160
  • Fax: 252-586-6720

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC001332
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: