Provider Demographics
NPI:1043248768
Name:COHEN, CELINA E (PHD)
Entity Type:Individual
Prefix:
First Name:CELINA
Middle Name:E
Last Name:COHEN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 COOPER RD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14617-3009
Mailing Address - Country:US
Mailing Address - Phone:585-336-3173
Mailing Address - Fax:585-336-3072
Practice Address - Street 1:350 COOPER RD
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14617-3009
Practice Address - Country:US
Practice Address - Phone:585-336-3173
Practice Address - Fax:585-336-3072
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2010-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY016245103TC0700X, 103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical