Provider Demographics
NPI:1841782943
Name:COHEN, ALYSSA GRACE (LCSW)
Entity Type:Individual
Prefix:
First Name:ALYSSA
Middle Name:GRACE
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 1:2 PARAGON WAY STE 800
Mailing Address - Street 2:
Mailing Address - City:FREEHOLD
Mailing Address - State:NJ
Mailing Address - Zip Code:07728-9573
Mailing Address - Country:US
Mailing Address - Phone:908-907-3606
Mailing Address - Fax:
Practice Address - Street 1:2 PARAGON WAY STE 800
Practice Address - Street 2:
Practice Address - City:FREEHOLD
Practice Address - State:NJ
Practice Address - Zip Code:07728-9573
Practice Address - Country:US
Practice Address - Phone:908-907-3606
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-04
Last Update Date:2022-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL06378000104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker