Provider Demographics
NPI:1457604084
Name:COHEN, HILARY HENEGAN (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:HILARY
Middle Name:HENEGAN
Last Name:COHEN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4300 RIDGEWOOD CENTER DR
Mailing Address - Street 2:UNIT A
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22192-5307
Mailing Address - Country:US
Mailing Address - Phone:703-283-0680
Mailing Address - Fax:703-580-7213
Practice Address - Street 1:4300 RIDGEWOOD CENTER DR
Practice Address - Street 2:UNIT A
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22192-5307
Practice Address - Country:US
Practice Address - Phone:703-283-0680
Practice Address - Fax:703-580-7213
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-19
Last Update Date:2012-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040079501041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical