Lucille G Cockerham, LCSW
Social Worker, Clinical in Jackson, MS. Individual provider (NPI-1).
NPI number1710072962
StatusActive
Last updated in NPPESJul 8, 2007
Details
- NPI
- 1710072962
- Entity type
- Individual (NPI-1)
- Name
- Ms. Lucille G Cockerham
- Credential
- LCSW
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Oct 4, 2006
- Last updated
- Jul 8, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | C1188 | MS | Yes |
Practice location
1500 E Woodrow WilsonJackson, MS 39216-5199
Phone 601-362-4471 · Fax 601-368-4409
Mailing address
454 Forest AveJackson, MS 39206
Phone 601-362-4471 · Fax 601-368-4409
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