Provider Demographics
NPI:1497834857
Name:COHEN, MARCIE LYNN (LCSW-C)
Entity Type:Individual
Prefix:MS
First Name:MARCIE
Middle Name:LYNN
Last Name:COHEN
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4911 COLUMBIA RD
Mailing Address - Street 2:APT B
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21044-1596
Mailing Address - Country:US
Mailing Address - Phone:410-740-9144
Mailing Address - Fax:
Practice Address - Street 1:6 PARK CENTER CT
Practice Address - Street 2:SUITE 103
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-5601
Practice Address - Country:US
Practice Address - Phone:410-356-3344
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD122411041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical