Provider Demographics
NPI:1073630547
Name:COHEN, CHERYL BETH (MSW, LCSW)
Entity Type:Individual
Prefix:MS
First Name:CHERYL
Middle Name:BETH
Last Name:COHEN
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:MS
Other - First Name:CHERYL
Other - Middle Name:BETH
Other - Last Name:BRICKEY, SIZER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW, LCSW
Mailing Address - Street 1:11317 JOHN ALLEN RD
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27614
Mailing Address - Country:US
Mailing Address - Phone:919-412-2556
Mailing Address - Fax:
Practice Address - Street 1:5854 FARINGDON PL
Practice Address - Street 2:#2
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-3931
Practice Address - Country:US
Practice Address - Phone:919-877-9925
Practice Address - Fax:888-470-4610
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-22
Last Update Date:2017-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0028181041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6002219Medicaid
NC1059 NOtherBLUE CROSS BLUE SHEILD