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General NPI Number Information
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NPI Number | 1780331801
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Entity Type | Individual
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Provider Name | AVA COHEN LSCW
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Gender | Female
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Dates
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Enumeration Date | 03/08/2022
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Last Update Date | 03/08/2022
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Provider Practice Location Address
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Address Line | 3401 STARRY NIGHT LOOP
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City | CASTLE ROCK
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State | CO
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Zip | 80109-3720
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Country | US
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Telephone | 303-880-1511
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Fax |
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Provider Business Mailing Address
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Address Line | 4833 FRONT ST UNIT 221B
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City | CASTLE ROCK
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State | CO
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Zip | 80104-7902
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Country | US
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Telephone |
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Fax |
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LCSW-1282
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License Number State | WY
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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 | CSW.09926085
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License Number State | CO
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