Provider Demographics
NPI:1851314538
Name:COHEN, DEBORAH (LICSW)
Entity Type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:
Last Name:COHEN
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 1:4 WALDO AVE
Mailing Address - Street 2:#3
Mailing Address - City:SOMERVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02143-4319
Mailing Address - Country:US
Mailing Address - Phone:617-666-2614
Mailing Address - Fax:
Practice Address - Street 1:100 WILLIAM T MORRISSEY BLVD
Practice Address - Street 2:UNIVERSITY OF MASSACHUSETTS BOSTON COUNSELING CENTER
Practice Address - City:DORCHESTER
Practice Address - State:MA
Practice Address - Zip Code:02125-3300
Practice Address - Country:US
Practice Address - Phone:617-287-5694
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10321031041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical