MEDICARE: BRADLEY COHEN LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	CW018303	PA

General Provider Information

NPI Number	:	1144985730
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRADLEY COHEN LCSW

Provider Business Mailing Address
First Line	:	127 BROADSTONE DR
Second Line	:
City	:	MARS
State	:	PA
Zip	:	16046-5209
Country	:	US
Telephone Number	:	412-951-9482
Fax Number	:

Provider Business Practice Location Address
First Line	:	810 CLAIRTON BLVD STE 600
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15236-5511
Country	:	US
Telephone Number	:	412-951-9482
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/08/2021
Last Update Date	:	11/08/2021

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Directions to “ BRADLEY COHEN LCSW” Practice Location

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