Provider Demographics
NPI:1417446600
Name:AMY COHEN, LISW-LLC
Entity Type:Organization
Organization Name:AMY COHEN, LISW-LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LIANN
Authorized Official - Middle Name:
Authorized Official - Last Name:SEALE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-489-8600
Mailing Address - Street 1:9403 KENWOOD RD
Mailing Address - Street 2:
Mailing Address - City:BLUE ASH
Mailing Address - State:OH
Mailing Address - Zip Code:45242-6895
Mailing Address - Country:US
Mailing Address - Phone:513-489-8600
Mailing Address - Fax:513-489-0123
Practice Address - Street 1:9403 KENWOOD RD
Practice Address - Street 2:
Practice Address - City:BLUE ASH
Practice Address - State:OH
Practice Address - Zip Code:45242-6895
Practice Address - Country:US
Practice Address - Phone:513-489-8600
Practice Address - Fax:513-489-0123
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-03
Last Update Date:2018-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI7693251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health