Provider Demographics
NPI:1780956920
Name:COHEN, JENNIFER (LPC)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:
Last Name:COHEN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 PAYNE RD
Mailing Address - Street 2:
Mailing Address - City:BETHEL
Mailing Address - State:CT
Mailing Address - Zip Code:06801-1242
Mailing Address - Country:US
Mailing Address - Phone:203-948-7390
Mailing Address - Fax:
Practice Address - Street 1:36 MILL PLAIN RD STE 312
Practice Address - Street 2:
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06811-5114
Practice Address - Country:US
Practice Address - Phone:203-948-7390
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-03
Last Update Date:2019-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002145101YM0800X
CT2145101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health