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NPI Code Detail

MEDICARE: ROBERTA COHEN M.ED., LCADC

MEDICARE:   ROBERTA  COHEN  M.ED., LCADC
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
1101YA0400XAddiction (Substance Use Disorder) CounselorLCA1709MD

General Provider Information

NPI Number : 1306262027
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROBERTA COHEN M.ED., LCADC
Provider Business Mailing Address
First Line : 705 CANNON RD
Second Line :
City : COLESVILLE
State : MD
Zip : 20904-3323
Country : US
Telephone Number : 301-613-8612
Fax Number :
Provider Business Practice Location Address
First Line : 705 CANNON RD
Second Line :
City : COLESVILLE
State : MD
Zip : 20904-3323
Country : US
Telephone Number : 301-613-8612
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/06/2014
Last Update Date : 03/06/2014

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Directions to “ ROBERTA COHEN M.ED., LCADC” Practice Location

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