Provider Demographics
NPI:1366297509
Name:COCHRAN, TERESA DAWN (LPC)
Entity type:Individual
Prefix:MRS
First Name:TERESA
Middle Name:DAWN
Last Name:COCHRAN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:270 ACACIA LN
Mailing Address - Street 2:
Mailing Address - City:LERONA
Mailing Address - State:WV
Mailing Address - Zip Code:25971-8701
Mailing Address - Country:US
Mailing Address - Phone:304-922-9407
Mailing Address - Fax:
Practice Address - Street 1:616 HARRISON ST
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:WV
Practice Address - Zip Code:24740-3141
Practice Address - Country:US
Practice Address - Phone:304-487-3487
Practice Address - Fax:681-282-5441
Is Sole Proprietor?:No
Enumeration Date:2024-04-22
Last Update Date:2024-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV2955101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health