Provider Demographics
NPI:1346409208
Name:COHEN, MARTHA B (LCSW-C)
Entity Type:Individual
Prefix:
First Name:MARTHA
Middle Name:B
Last Name:COHEN
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5722 CROSS COUNTRY BLVD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21209-4230
Mailing Address - Country:US
Mailing Address - Phone:443-310-8622
Mailing Address - Fax:
Practice Address - Street 1:5722 CROSS COUNTRY BLVD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21209-4230
Practice Address - Country:US
Practice Address - Phone:443-310-8622
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-05
Last Update Date:2008-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD090271041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical