Provider Demographics
NPI:1558604637
Name:COHEN, AMY M (LCPC)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:M
Last Name:COHEN
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1038 CAREN DR
Mailing Address - Street 2:
Mailing Address - City:ELDERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:21784-8403
Mailing Address - Country:US
Mailing Address - Phone:443-831-8089
Mailing Address - Fax:
Practice Address - Street 1:5420 KLEE MILL RD S STE 6
Practice Address - Street 2:
Practice Address - City:SYKESVILLE
Practice Address - State:MD
Practice Address - Zip Code:21784-9230
Practice Address - Country:US
Practice Address - Phone:443-831-8089
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-27
Last Update Date:2014-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC5535101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional