Provider Demographics
NPI:1811076177
Name:COHEN, ROBERT (LICSW)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:
Last Name:COHEN
Suffix:
Gender:M
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 CENTRAL ST
Mailing Address - Street 2:SUITE 222
Mailing Address - City:ARLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02476-4800
Mailing Address - Country:US
Mailing Address - Phone:781-641-4100
Mailing Address - Fax:781-641-4101
Practice Address - Street 1:7 CENTRAL ST
Practice Address - Street 2:SUITE 222
Practice Address - City:ARLINGTON
Practice Address - State:MA
Practice Address - Zip Code:02476-4800
Practice Address - Country:US
Practice Address - Phone:781-641-4100
Practice Address - Fax:781-641-4101
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1028211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA102821OtherTUFTS HEALTH PLAN ID
MA102821OtherSTATE LICENSE NUMBER
MA008444OtherVALUEOPTIONS ID
MAP01181OtherBCBS PROVIDER NUMBER
MAP01181Medicare ID - Type Unspecified
MA102821OtherSTATE LICENSE NUMBER