=====================================================
General NPI Number Information
=====================================================
NPI Number | 1417429838
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | LINDSAY COCHRAN,LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/24/2018
-----------------------------------------------------
Last Update Date | 12/24/2018
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 741 PIEDMONT AVE NE STE 500
-----------------------------------------------------
City | ATLANTA
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30308-1480
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 678-931-9760
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 747 RALPH MCGILL BLVD NE UNIT 1035
-----------------------------------------------------
City | ATLANTA
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30312-1132
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 248-840-1861
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | LINDSAY COCHRAN
-----------------------------------------------------
Credential | LPC
-----------------------------------------------------
Telephone | 248-840-1861
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101Y00000X
-----------------------------------------------------
Taxonomy Name | Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------