Provider Demographics
NPI:1174857353
Name:COHEN-FILIPIC, JESSYE (PHD)
Entity Type:Individual
Prefix:
First Name:JESSYE
Middle Name:
Last Name:COHEN-FILIPIC
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 1:111 NORTHVIEW RD
Mailing Address - Street 2:
Mailing Address - City:ITHACA
Mailing Address - State:NY
Mailing Address - Zip Code:14850-6039
Mailing Address - Country:US
Mailing Address - Phone:804-301-3621
Mailing Address - Fax:
Practice Address - Street 1:111 NORTHVIEW RD
Practice Address - Street 2:
Practice Address - City:ITHACA
Practice Address - State:NY
Practice Address - Zip Code:14850-6039
Practice Address - Country:US
Practice Address - Phone:804-301-3621
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-22
Last Update Date:2017-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY022014103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling