Provider Demographics
NPI:1861683229
Name:COHEN, STUART M (MSW)
Entity Type:Individual
Prefix:
First Name:STUART
Middle Name:M
Last Name:COHEN
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:736 SPEEDWELL AVE
Mailing Address - Street 2:STE 3
Mailing Address - City:MORRIS PLAINS
Mailing Address - State:NJ
Mailing Address - Zip Code:07950-2254
Mailing Address - Country:US
Mailing Address - Phone:973-216-9493
Mailing Address - Fax:201-367-3188
Practice Address - Street 1:736 SPEEDWELL AVE
Practice Address - Street 2:
Practice Address - City:MORRIS PLAINS
Practice Address - State:NJ
Practice Address - Zip Code:07950-2254
Practice Address - Country:US
Practice Address - Phone:973-216-9493
Practice Address - Fax:201-367-3188
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-09
Last Update Date:2020-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC001764001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
134825Medicare PIN