Provider Demographics
NPI:1326232844
Name:COHEN-MEISELMAN, HEATHER MINDY (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:MINDY
Last Name:COHEN-MEISELMAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8067 MIZNER LN
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33433-1126
Mailing Address - Country:US
Mailing Address - Phone:561-703-3401
Mailing Address - Fax:
Practice Address - Street 1:8067 MIZNER LN
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33433-1126
Practice Address - Country:US
Practice Address - Phone:561-703-3401
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-28
Last Update Date:2007-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW60771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE6166Medicare PIN