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NPI Code Detail

MEDICARE: MICHAEL COHEN LISW-S

MEDICARE: MICHAEL COHEN LISW-S
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
1104100000XSocial WorkerI.160014OH

General Provider Information

NPI Number : 1285801126
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL COHEN LISW-S
Provider Business Mailing Address
First Line : 27642 CAROLINE CIR APT B
Second Line :
City : CLEVELAND
State : OH
Zip : 44145-1127
Country : US
Telephone Number : 440-503-1905
Fax Number :
Provider Business Practice Location Address
First Line : 1744 PAYNE AVE
Second Line :
City : CLEVELAND
State : OH
Zip : 44114-2910
Country : US
Telephone Number : 216-623-6555
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/09/2008
Last Update Date : 12/27/2017

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