Provider Demographics
NPI:1639722606
Name:HOLIFIELD COHEN, CYNTHIA GAIL (LCSW)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:GAIL
Last Name:HOLIFIELD COHEN
Suffix:
Gender:
Credentials:LCSW
Other - Prefix:
Other - First Name:CYNTHIA
Other - Middle Name:GAIL
Other - Last Name:HOLIFIELD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1201 BROAD ROCK BLVD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23249-0001
Mailing Address - Country:US
Mailing Address - Phone:850-284-3735
Mailing Address - Fax:
Practice Address - Street 1:1201 BROAD ROCK BLVD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23249-8216
Practice Address - Country:US
Practice Address - Phone:850-284-3735
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-18
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX637631041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical