Provider Demographics
NPI:1841795531
Name:COHEN, CAROLINE A
Entity type:Individual
Prefix:
First Name:CAROLINE
Middle Name:A
Last Name:COHEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 PARSONAGE RD STE 318
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08837-2429
Mailing Address - Country:US
Mailing Address - Phone:732-204-1635
Mailing Address - Fax:
Practice Address - Street 1:4602 E UNIVERSITY DR STE 130
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85034-7430
Practice Address - Country:US
Practice Address - Phone:888-754-0398
Practice Address - Fax:954-982-6491
Is Sole Proprietor?:No
Enumeration Date:2018-03-26
Last Update Date:2021-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X
AZBEH-000649103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician