Provider Demographics
NPI:1801891700
Name:COHEN, DORIS (EDD)
Entity type:Individual
Prefix:DR
First Name:DORIS
Middle Name:
Last Name:COHEN
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:90 CONZ ST
Mailing Address - Street 2:
Mailing Address - City:NORTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01060-3881
Mailing Address - Country:US
Mailing Address - Phone:413-586-2960
Mailing Address - Fax:413-584-2738
Practice Address - Street 1:90 CONZ ST
Practice Address - Street 2:
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060-3881
Practice Address - Country:US
Practice Address - Phone:413-586-2960
Practice Address - Fax:413-584-2738
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA6070103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0500208Medicaid
MAY62151Medicare ID - Type Unspecified