MEDICARE: MAUREEN ELIZABETH COHEN LMHC

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	101YM0800X	Mental Health Counselor	MH9968	FL

General Provider Information

NPI Number	:	1992868079
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAUREEN ELIZABETH COHEN LMHC

Provider Business Mailing Address
First Line	:	PO BOX 601064
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32260-1064
Country	:	US
Telephone Number	:	904-210-8059
Fax Number	:

Provider Business Practice Location Address
First Line	:	157 HAMPTON POINT DR
Second Line	:	SUITE 1
City	:	ST AUGUSTINE
State	:	FL
Zip	:	32092-3053
Country	:	US
Telephone Number	:	904-210-8059
Fax Number	:

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

Provider Enumeration Date	:	12/19/2006
Last Update Date	:	03/18/2015

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