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General NPI Number Information
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NPI Number | 1699030080
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Entity Type | Individual
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Provider Name | SARAH GRACE COCHRAN MSW, LISW
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Gender | Female
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Dates
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Enumeration Date | 07/11/2012
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Last Update Date | 11/14/2018
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Provider Practice Location Address
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Address Line | 2821 WOODLAWN AVE NW
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City | CANTON
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State | OH
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Zip | 44708-1423
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Country | US
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Telephone | 330-479-2378
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Fax | 330-479-7456
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Provider Business Mailing Address
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Address Line | 2821 WOODLAWN AVE NW
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City | CANTON
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State | OH
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Zip | 44708-1423
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Country | US
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Telephone | 330-479-2378
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Fax | 330-479-7456
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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 | I.1801211
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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