Provider Demographics
NPI:1659575561
Name:COHEN, CARRIE ANN (LCSW)
Entity Type:Individual
Prefix:
First Name:CARRIE
Middle Name:ANN
Last Name:COHEN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:806 W DE LEON ST
Mailing Address - Street 2:SUITE 203
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33606-2731
Mailing Address - Country:US
Mailing Address - Phone:813-784-2442
Mailing Address - Fax:
Practice Address - Street 1:806 W DE LEON ST
Practice Address - Street 2:SUITE 203
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33606-2731
Practice Address - Country:US
Practice Address - Phone:813-784-2442
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW67481041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical