Healthcare Provider Details

I. General information

NPI: 1578610655
Provider Name (Legal Business Name): RONA L COHEN LCMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/04/2007
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35 CATHERINE ST
SAINT ALBANS VT
05478-2205
US

IV. Provider business mailing address

PO BOX 527
ENOSBURG FALLS VT
05450-0527
US

V. Phone/Fax

Practice location:
  • Phone: 802-658-0040
  • Fax: 802-658-0216
Mailing address:
  • Phone: 802-933-5553
  • Fax: 802-658-0216

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number068-0000346
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: