Provider Demographics
NPI:1346365764
Name:COLBY COHEN-ARCHER, PH.D., PLLC
Entity Type:Organization
Organization Name:COLBY COHEN-ARCHER, PH.D., PLLC
Other - Org Name:COLBY COHEN-ARCHER, PH.D.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:LICENSED PSYCHOLOGIST, OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:COLBY
Authorized Official - Middle Name:REBECCA
Authorized Official - Last Name:COHEN-ARCHER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:859-327-6459
Mailing Address - Street 1:2365 HARRODSBURG RD
Mailing Address - Street 2:STE B225
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40504-3335
Mailing Address - Country:US
Mailing Address - Phone:859-327-6459
Mailing Address - Fax:
Practice Address - Street 1:2365 HARRODSBURG RD
Practice Address - Street 2:STE B225
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40504-3335
Practice Address - Country:US
Practice Address - Phone:859-327-6459
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-21
Last Update Date:2016-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY129016103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY00435001Medicare PIN