Healthcare Provider Details

I. General information

NPI: 1891082202
Provider Name (Legal Business Name): SHEILA SMITH COHEN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/06/2011
Last Update Date: 07/06/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1790 30TH STREET SUITE 308
BOULDER CO
80301
US

IV. Provider business mailing address

815 W MULBERRY ST
LOUISVILLE CO
80027-9403
US

V. Phone/Fax

Practice location:
  • Phone: 303-440-0205
  • Fax: 303-440-0209
Mailing address:
  • Phone: 303-664-0025
  • Fax: 303-440-0209

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number1302
License Number StateCO

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: