Healthcare Provider Details

I. General information

NPI: 1083857502
Provider Name (Legal Business Name): MELANIE JOY COHN-HOPWOOD MSW, LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MS. MELANIE JOY COHN

II. Dates (important events)

Enumeration Date: 04/14/2009
Last Update Date: 05/12/2021
Certification Date: 05/05/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 EARHART STREET UNIT 724
CAMBRIDGE MA
02141-1940
US

IV. Provider business mailing address

P O BOX 410039 ATTN: MELANIE COHN-HOPWOOD, LICSW/LIFECYCLES THERAPY
CAMBRIDGE MA
02141
US

V. Phone/Fax

Practice location:
  • Phone: 857-342-3953
  • Fax: 617-849-5584
Mailing address:
  • Phone: 857-342-3953
  • Fax: 617-553-1945

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number113364
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: