Provider Demographics
NPI:1184017972
Name:MAUREEN COHEN, LICENSED MENTAL HEALTH COUNSELOR
Entity type:Organization
Organization Name:MAUREEN COHEN, LICENSED MENTAL HEALTH COUNSELOR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LMHC
Authorized Official - Prefix:
Authorized Official - First Name:MAUREEN
Authorized Official - Middle Name:
Authorized Official - Last Name:COHEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-210-8059
Mailing Address - Street 1:PO BOX 601064
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32260-1064
Mailing Address - Country:US
Mailing Address - Phone:904-210-8059
Mailing Address - Fax:
Practice Address - Street 1:157 HAMPTON POINT DR
Practice Address - Street 2:SUITE 1
Practice Address - City:ST AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32092-3053
Practice Address - Country:US
Practice Address - Phone:904-210-8059
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-18
Last Update Date:2015-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH9968101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty