Provider Demographics
NPI:1366749939
Name:COCHRAN, VIRGINIA DEAN
Entity type:Individual
Prefix:MS
First Name:VIRGINIA
Middle Name:DEAN
Last Name:COCHRAN
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:VIRGINIA
Other - Middle Name:DEAN
Other - Last Name:COCHRAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMHP, LPC
Mailing Address - Street 1:600 4TH ST
Mailing Address - Street 2:
Mailing Address - City:SIOUX CITY
Mailing Address - State:IA
Mailing Address - Zip Code:51101-1750
Mailing Address - Country:US
Mailing Address - Phone:712-574-4357
Mailing Address - Fax:712-276-3314
Practice Address - Street 1:600 4TH ST
Practice Address - Street 2:
Practice Address - City:SIOUX CITY
Practice Address - State:IA
Practice Address - Zip Code:51101-1750
Practice Address - Country:US
Practice Address - Phone:712-574-4357
Practice Address - Fax:712-276-3314
Is Sole Proprietor?:No
Enumeration Date:2011-02-17
Last Update Date:2013-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1053101YM0800X
NE821101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional