Provider Demographics
NPI:1689933517
Name:PRESS, BONNIE COHEN (LICSW)
Entity Type:Individual
Prefix:MRS
First Name:BONNIE
Middle Name:COHEN
Last Name:PRESS
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1463 BEACON ST
Mailing Address - Street 2:
Mailing Address - City:WABAN
Mailing Address - State:MA
Mailing Address - Zip Code:02468-1602
Mailing Address - Country:US
Mailing Address - Phone:617-964-3934
Mailing Address - Fax:
Practice Address - Street 1:1463 BEACON ST
Practice Address - Street 2:
Practice Address - City:WABAN
Practice Address - State:MA
Practice Address - Zip Code:02468-1602
Practice Address - Country:US
Practice Address - Phone:617-964-3934
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-12
Last Update Date:2012-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1161151041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical