Provider Demographics
NPI:1578610655
Name:COHEN, RONA L (LCMHC)
Entity Type:Individual
Prefix:
First Name:RONA
Middle Name:L
Last Name:COHEN
Suffix:
Gender:F
Credentials:LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 527
Mailing Address - Street 2:
Mailing Address - City:ENOSBURG FALLS
Mailing Address - State:VT
Mailing Address - Zip Code:05450-0527
Mailing Address - Country:US
Mailing Address - Phone:802-933-5553
Mailing Address - Fax:802-658-0216
Practice Address - Street 1:35 CATHERINE ST
Practice Address - Street 2:
Practice Address - City:SAINT ALBANS
Practice Address - State:VT
Practice Address - Zip Code:05478-2205
Practice Address - Country:US
Practice Address - Phone:802-658-0040
Practice Address - Fax:802-658-0216
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT068-0000346101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT00039903OtherBC BS PROVIDER NUMBER
VT1011079Medicaid