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General NPI Number Information
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NPI Number | 1912619891
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Entity Type | Individual
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Provider Name | MERIDIE MARIE MACHADO COHEN LCSW
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Gender | Female
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Dates
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Enumeration Date | 12/22/2022
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Last Update Date | 02/02/2024
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Provider Practice Location Address
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Address Line | 620 JHN PAUL JNS CIR
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City | PORTSMOUTH
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State | VA
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Zip | 23708-2111
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Country | US
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Telephone | 757-953-5818
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Fax |
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Provider Business Mailing Address
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Address Line | 620 JHN PAUL JNS CIR
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City | PORTSMOUTH
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State | VA
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Zip | 23708-2111
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 0733008460
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 0732009641
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | CSW03045
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License Number State | RI
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Taxonomy #4
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 150.110296
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License Number State | IL
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