Provider Demographics
NPI:1376642074
Name:COHEN, SHERYL LYNN (PHD)
Entity Type:Individual
Prefix:DR
First Name:SHERYL
Middle Name:LYNN
Last Name:COHEN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9200 MONTGOMERY ROAD
Mailing Address - Street 2:#10A
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45242
Mailing Address - Country:US
Mailing Address - Phone:513-791-7022
Mailing Address - Fax:513-791-7004
Practice Address - Street 1:9200 MONTGOMERY ROAD
Practice Address - Street 2:#10A
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45242
Practice Address - Country:US
Practice Address - Phone:513-791-7022
Practice Address - Fax:513-791-7004
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2009-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3363103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
COCP02842Medicare ID - Type Unspecified