Provider Demographics
NPI:1942477880
Name:COHEN, MARK (DSW,MSW)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:
Last Name:COHEN
Suffix:
Gender:M
Credentials:DSW,MSW
Other - Prefix:
Other - First Name:MARK
Other - Middle Name:
Other - Last Name:COHEN, DSW, PC
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DSW, MSW
Mailing Address - Street 1:43 PARK LN
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE CENTRE
Mailing Address - State:NY
Mailing Address - Zip Code:11570-1831
Mailing Address - Country:US
Mailing Address - Phone:516-536-1570
Mailing Address - Fax:
Practice Address - Street 1:43 PARK LN
Practice Address - Street 2:SUITE 1
Practice Address - City:ROCKVILLE CENTRE
Practice Address - State:NY
Practice Address - Zip Code:11570-1831
Practice Address - Country:US
Practice Address - Phone:516-536-1570
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-09
Last Update Date:2008-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYLCSW PR020617101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health