Provider Demographics
NPI:1467473215
Name:COHEN, LAURA (LCSW)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:
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 1:401 HAMBURG TPKE STE 302
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07470-2139
Mailing Address - Country:US
Mailing Address - Phone:973-790-9222
Mailing Address - Fax:973-790-0671
Practice Address - Street 1:401 HAMBURG TPKE STE 302
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:NJ
Practice Address - Zip Code:07470-2139
Practice Address - Country:US
Practice Address - Phone:973-790-9222
Practice Address - Fax:973-790-9222
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2021-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC046679001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ054314N90Medicare ID - Type Unspecified
NJ054314VNDMedicare ID - Type Unspecified
NJ039874Medicare ID - Type UnspecifiedGROUP NUMBER
NJ103241Medicare ID - Type UnspecifiedGROUP NUMBER