MEDICARE: MRS. MIRIAM GALPER COHEN LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	CW-000704-L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	708765	OTHER	PA	BLUE SHIELD

General Provider Information

NPI Number	:	1023186608
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MIRIAM GALPER COHEN LCSW

Provider Business Mailing Address
First Line	:	61 CHELFIELD RD
Second Line	:
City	:	GLENSIDE
State	:	PA
Zip	:	19038-1401
Country	:	US
Telephone Number	:	215-884-8235
Fax Number	:	215-884-4915

Provider Business Practice Location Address
First Line	:	MEDICAL TOWER SUITE 1509
Second Line	:	255 SOUTH 17TH STREET
City	:	PHILADELPHIA
State	:	PA
Zip	:	19103-6231
Country	:	US
Telephone Number	:	215-884-8235
Fax Number	:	215-884-4915

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/01/2006
Last Update Date	:	02/08/2026

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