Provider Demographics
NPI:1184894610
Name:COHEN, STEFANIE MONICA (LMSW)
Entity type:Individual
Prefix:MRS
First Name:STEFANIE
Middle Name:MONICA
Last Name:COHEN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:MISS
Other - First Name:STEFANIE
Other - Middle Name:MONICA
Other - Last Name:FREED
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMSW
Mailing Address - Street 1:1808 ROUTE 6
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:NY
Mailing Address - Zip Code:10512-2356
Mailing Address - Country:US
Mailing Address - Phone:845-225-2700
Mailing Address - Fax:845-225-3207
Practice Address - Street 1:1808 ROUTE 6
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:NY
Practice Address - Zip Code:10512-2356
Practice Address - Country:US
Practice Address - Phone:845-225-2700
Practice Address - Fax:845-225-3207
Is Sole Proprietor?:No
Enumeration Date:2008-03-12
Last Update Date:2008-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0721001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY072100OtherSTATE LICENSE