Provider Demographics
NPI:1245209493
Name:COHEN, CAROLYN (LMFT)
Entity Type:Individual
Prefix:MS
First Name:CAROLYN
Middle Name:
Last Name:COHEN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80 BARCLAY SHOPPING CENTER
Mailing Address - Street 2:SUITE 1
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08034
Mailing Address - Country:US
Mailing Address - Phone:856-429-3900
Mailing Address - Fax:732-477-2594
Practice Address - Street 1:80 BARCLAY SHOPPING CENTER
Practice Address - Street 2:SUITE 1
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08034
Practice Address - Country:US
Practice Address - Phone:856-429-3900
Practice Address - Fax:732-477-2594
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-17
Last Update Date:2009-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC003925001041C0700X
NJ37FI00120200106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJCO634607Medicare ID - Type Unspecified
NJ634607Medicare UPIN
634607Medicare UPIN