Provider Demographics
NPI:1457012072
Name:COHEN, ANNA SOPHIA MOSCOW (LCSW)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:SOPHIA MOSCOW
Last Name:COHEN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8506 MILLWAY DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78757-7543
Mailing Address - Country:US
Mailing Address - Phone:734-476-1235
Mailing Address - Fax:
Practice Address - Street 1:3006 BEE CAVES RD STE D300
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78746-6735
Practice Address - Country:US
Practice Address - Phone:734-476-1235
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-05
Last Update Date:2022-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1066151041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical