Provider Demographics
NPI:1700197456
Name:COHEN, DIANA K (LCSW-R)
Entity Type:Individual
Prefix:MS
First Name:DIANA
Middle Name:K
Last Name:COHEN
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:MS
Other - First Name:DIANA
Other - Middle Name:
Other - Last Name:KORALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW-R
Mailing Address - Street 1:1 SUMMIT AVE
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10606-3003
Mailing Address - Country:US
Mailing Address - Phone:914-872-5267
Mailing Address - Fax:914-948-0299
Practice Address - Street 1:1 SUMMIT AVE
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10606-3003
Practice Address - Country:US
Practice Address - Phone:914-872-5267
Practice Address - Fax:914-948-0299
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-28
Last Update Date:2010-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY054336-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical