Provider Demographics
NPI:1598974859
Name:COHEN, ERIN TRACY (LCSW)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:TRACY
Last Name:COHEN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:T
Other - Last Name:HAUPTMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:276 5TH AVE
Mailing Address - Street 2:SUITE 507B, OFFICE B6
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-4509
Mailing Address - Country:US
Mailing Address - Phone:516-996-7321
Mailing Address - Fax:
Practice Address - Street 1:276 5TH AVE
Practice Address - Street 2:SUITE 507B, OFFICE B6
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-4509
Practice Address - Country:US
Practice Address - Phone:516-996-7321
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2007-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0707001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical