Healthcare Provider Details

I. General information

NPI: 1700087657
Provider Name (Legal Business Name): CHERYL COHEN PMHNP-BC, L.M.F.T
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/29/2007
Last Update Date: 04/02/2026
Certification Date: 04/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

207 STORRS RD
MANSFIELD CENTER CT
06250-1638
US

IV. Provider business mailing address

207 STORRS RD
MANSFIELD CENTER CT
06250-1638
US

V. Phone/Fax

Practice location:
  • Phone: 860-942-8826
  • Fax:
Mailing address:
  • Phone: 860-942-8826
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number12443
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number000937
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: