Individual
TYRA ROSE COCHRAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, LSW
Contact information
Practice address
7576 SENECA TRAIL, RT 219 N, HILLSBORO, WV 24946
(304) 742-2025
(304) 653-4200
Mailing address
390 MCCLUNG RD, RENICK, WV 24966-7326
(304) 956-0508
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
SW071915174
WV
101YM0800X
Mental Health Counselor
SW071915174
WV
101YP2500X
Professional Counselor
SW071915174
WV
104100000X
Social Worker
Primary
SW071915174
WV
1041C0700X
Clinical Social Worker
SW071915174
WV
2080P0006X
Developmental - Behavioral Pediatrics Physician
SW071915174
WV
251S00000X
Community/Behavioral Health Agency
SW071915174
WV
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
SW071915174
WV
Other
Enumeration date
08/08/2019
Last updated
08/08/2019
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