MEDICARE: JOELLE COHEN

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	IMH25411	FL

General Provider Information

NPI Number	:	1033949045
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOELLE COHEN

Provider Business Mailing Address
First Line	:	3102 NW 63RD ST
Second Line	:
City	:	BOCA RATON
State	:	FL
Zip	:	33496-3907
Country	:	US
Telephone Number	:	561-901-0745
Fax Number	:

Provider Business Practice Location Address
First Line	:	3100 S FEDERAL HWY STE C
Second Line	:
City	:	DELRAY BEACH
State	:	FL
Zip	:	33483-3321
Country	:	US
Telephone Number	:	561-408-1098
Fax Number	:

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

Provider Enumeration Date	:	08/05/2024
Last Update Date	:	08/05/2024

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