Healthcare Provider Details

I. General information

NPI: 1710979901
Provider Name (Legal Business Name): DAVID COCKSON LMHP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/16/2005
Last Update Date: 01/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

214 W 6TH ST SUITE 2
YORK NE
68467-2903
US

IV. Provider business mailing address

715 N KANSAS AVE
HASTINGS NE
68901-4453
US

V. Phone/Fax

Practice location:
  • Phone: 402-362-7430
  • Fax:
Mailing address:
  • Phone: 402-463-7711
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number855
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: