Provider Demographics
NPI:1376842062
Name:COHAN, BEATTY CYNTHIA (MSW, LCSW)
Entity Type:Individual
Prefix:MRS
First Name:BEATTY
Middle Name:CYNTHIA
Last Name:COHAN
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12307 GREENBRIER WAY
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD RANCH
Mailing Address - State:FL
Mailing Address - Zip Code:34202-2922
Mailing Address - Country:US
Mailing Address - Phone:941-955-6116
Mailing Address - Fax:
Practice Address - Street 1:12307 GREENBRIER WAY
Practice Address - Street 2:
Practice Address - City:LAKEWOOD RANCH
Practice Address - State:FL
Practice Address - Zip Code:34202-2922
Practice Address - Country:US
Practice Address - Phone:941-955-6116
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-21
Last Update Date:2011-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL61301041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical