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General NPI Number Information
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NPI Number | 1487775193
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Entity Type | Individual
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Provider Name | JUDI L COHEN LCSWR
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Gender | Female
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Dates
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Enumeration Date | 04/02/2007
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Last Update Date | 02/08/2025
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Provider Practice Location Address
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Address Line | 1087 FULTON RD
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City | LISBON
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State | NY
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Zip | 13658-3143
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Country | US
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Telephone | 315-322-6158
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Fax |
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Provider Business Mailing Address
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Address Line | 50 LEROY ST SUITE 1
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City | POTSDAM
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State | NY
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Zip | 13676-1786
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Country | US
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Telephone | 315-265-3300
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Fax | 315-261-6025
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | R049961
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | R049961
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License Number State | NY
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