Provider Demographics
NPI:1629204516
Name:COHEN, MARY ANNE (MSW)
Entity Type:Individual
Prefix:MS
First Name:MARY ANNE
Middle Name:
Last Name:COHEN
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:490 3RD ST
Mailing Address - Street 2:APT. 5
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11215-2971
Mailing Address - Country:US
Mailing Address - Phone:718-788-6986
Mailing Address - Fax:
Practice Address - Street 1:490 3RD ST
Practice Address - Street 2:APT. 5
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215-2971
Practice Address - Country:US
Practice Address - Phone:718-788-6986
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-05
Last Update Date:2009-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPR0140341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical