=====================================================
General NPI Number Information
=====================================================
NPI Number | 1831202571
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ADAM E COHEN MSW
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/16/2006
-----------------------------------------------------
Last Update Date | 02/02/2012
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 333 MAYNARD ST SUITE 402
-----------------------------------------------------
City | ANN ARBOR
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48104-2293
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 734-945-6850
-----------------------------------------------------
Fax | 734-929-4913
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3150 PLATT RD
-----------------------------------------------------
City | ANN ARBOR
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48108-1800
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 734-945-6850
-----------------------------------------------------
Fax | 734-929-4913
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number | 6801067944
-----------------------------------------------------
License Number State | MI
-----------------------------------------------------