Healthcare Provider Details

I. General information

NPI: 1245656115
Provider Name (Legal Business Name): LINDA COCHRUM LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LINDA COCHRUM MS, LPCC

II. Dates (important events)

Enumeration Date: 03/14/2014
Last Update Date: 01/26/2022
Certification Date: 01/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5501 WILSHIRE AVE NE STE C
ALBUQUERQUE NM
87113-2569
US

IV. Provider business mailing address

5501 WILSHIRE AVE NE STE C
ALBUQUERQUE NM
87113-2569
US

V. Phone/Fax

Practice location:
  • Phone: 505-237-4020
  • Fax:
Mailing address:
  • Phone: 505-237-4020
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: