Provider Demographics
NPI:1467883728
Name:COHOON, GRETCHEN DEE (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:GRETCHEN
Middle Name:DEE
Last Name:COHOON
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:MRS
Other - First Name:GRETCHEN
Other - Middle Name:DEE
Other - Last Name:BLACKMORE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMSW
Mailing Address - Street 1:1309 FOSTER AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11230-1511
Mailing Address - Country:US
Mailing Address - Phone:718-282-0010
Mailing Address - Fax:
Practice Address - Street 1:1309 FOSTER AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11230-1511
Practice Address - Country:US
Practice Address - Phone:718-282-0010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-11
Last Update Date:2013-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY079209104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker