Provider Demographics
NPI:1215416649
Name:COHEN, JENNIFER LIEBMAN (MSW, MA)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LIEBMAN
Last Name:COHEN
Suffix:
Gender:F
Credentials:MSW, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 RIVER ST
Mailing Address - Street 2:
Mailing Address - City:BILLERICA
Mailing Address - State:MA
Mailing Address - Zip Code:01821-1827
Mailing Address - Country:US
Mailing Address - Phone:978-528-8747
Mailing Address - Fax:
Practice Address - Street 1:35 RIVER ST
Practice Address - Street 2:
Practice Address - City:BILLERICA
Practice Address - State:MA
Practice Address - Zip Code:01821-1827
Practice Address - Country:US
Practice Address - Phone:978-528-8747
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-07
Last Update Date:2018-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10264761041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical