Healthcare Provider Details

I. General information

NPI: 1649117045
Provider Name (Legal Business Name): KIMBERLY COHEN PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/02/2026
Last Update Date: 05/02/2026
Certification Date: 05/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 N 24TH ST
PHOENIX AZ
85008-6056
US

IV. Provider business mailing address

501 N 24TH ST
PHOENIX AZ
85008-6056
US

V. Phone/Fax

Practice location:
  • Phone: 602-561-7227
  • Fax:
Mailing address:
  • Phone: 602-220-6367
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number3291
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: