Provider Demographics
NPI:1760535488
Name:COHEN, EMILY JANE (LCSW)
Entity Type:Individual
Prefix:MISS
First Name:EMILY
Middle Name:JANE
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 1:1530 S STATE ST APT 15E
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60605-2972
Mailing Address - Country:US
Mailing Address - Phone:773-655-9404
Mailing Address - Fax:
Practice Address - Street 1:1530 S STATE ST APT 15E
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60605-2972
Practice Address - Country:US
Practice Address - Phone:773-655-9404
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-18
Last Update Date:2021-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY25508811041C0700X
IL1490110321041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical