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General NPI Number Information
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NPI Number | 1124675145
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Entity Type | Individual
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Provider Name | SEAN COCHRANE
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Gender | Male
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Dates
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Enumeration Date | 08/23/2019
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Last Update Date | 08/23/2019
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Provider Practice Location Address
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Address Line | 9 HILLCREST AVE
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City | RANDOLPH
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State | ME
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Zip | 04346-5131
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Country | US
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Telephone | 207-582-9205
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Fax | 207-582-4360
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Provider Business Mailing Address
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Address Line | 901 WASHINGTON AVE STE 100
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City | PORTLAND
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State | ME
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Zip | 04103-2842
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Country | US
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Telephone | 207-871-1200
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Fax | 207-871-1232
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | MC18246
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License Number State | ME
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