Healthcare Provider Details

I. General information

NPI: 1205018447
Provider Name (Legal Business Name): JANET COHEN PHD, LCSW-C, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/29/2007
Last Update Date: 08/27/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6525 N CHARLES ST SUITE 137
TOWSON MD
21204-6872
US

IV. Provider business mailing address

6525 N CHARLES ST SUITE 137
TOWSON MD
21204-6872
US

V. Phone/Fax

Practice location:
  • Phone: 410-296-7331
  • Fax: 410-882-5977
Mailing address:
  • Phone: 410-296-7331
  • Fax: 410-882-5977

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number06795
License Number StateMD

VII. Legacy identifiers

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

# 1
IdentifierH1390001
Identifier TypeOTHER
Identifier StateMD
Identifier IssuerFEDERAL CAREFIRST
# 2
IdentifierQS76J
Identifier TypeOTHER
Identifier StateMD
Identifier IssuerCAREFIRST BCBSMD
# 3
IdentifierH1390001
Identifier TypeOTHER
Identifier StateMD
Identifier IssuerBLUE CHOICE

VIII. Authorized Official

Name: DR. JANET COHEN
Title or Position: OWNER
Credential: PHD
Phone: 410-296-7331