Individual ProviderGavin CoganSocial WorkerBehavioral Health & Social Service ProvidersPractice Address22001 Fairmount Blvd, Shaker Heights, OH 44118-4819(216) 932-2800PECOS EnrollmentBased on the most recent information from CMS, provider Gavin Cogan does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 3 days ago.Profile DetailsProvider ID1447996624Provider TypeIndividualFull NameCogan, GavinGenderMaleSole ProprietorNoEnumeration Date5/10/2022Last Updated10/3/2022Contact InformationPractice LocationPractice Address22001 Fairmount Blvd, Shaker Heights, OH 44118-4819Phone(216) 932-2800FaxUnlisted FaxMailing LocationMailing Address22001 Fairmount Blvd, Shaker Heights, OH 44118-4819Phone(216) 932-2800FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode1041C0700XPrimaryDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicense2208227OhioCode171M00000XDescriptionCase Manager/Care CoordinatorOther Service ProvidersLicenseUnlisted Issuer