Provider Demographics
NPI:1700316387
Name:COHEN, GIGI LYNN (LMSW)
Entity Type:Individual
Prefix:
First Name:GIGI
Middle Name:LYNN
Last Name:COHEN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1115 WESTPORT DR STE D2
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN
Mailing Address - State:KS
Mailing Address - Zip Code:66502-2871
Mailing Address - Country:US
Mailing Address - Phone:785-527-3373
Mailing Address - Fax:785-200-3766
Practice Address - Street 1:1115 WESTPORT DR STE D2
Practice Address - Street 2:
Practice Address - City:MANHATTAN
Practice Address - State:KS
Practice Address - Zip Code:66502-2871
Practice Address - Country:US
Practice Address - Phone:785-527-3373
Practice Address - Fax:785-200-3766
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1311104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS00000000000000Medicaid