Provider Demographics
NPI:1932969037
Name:COHEN, JOANNA LOUISE
Entity Type:Individual
Prefix:
First Name:JOANNA
Middle Name:LOUISE
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 1:15827 W CARIBBEAN LN
Mailing Address - Street 2:
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85379-6241
Mailing Address - Country:US
Mailing Address - Phone:480-249-0230
Mailing Address - Fax:
Practice Address - Street 1:15827 W CARIBBEAN LN
Practice Address - Street 2:
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85379-6241
Practice Address - Country:US
Practice Address - Phone:480-249-0230
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-19
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLMSW-19925101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health