Provider Demographics
NPI:1063558799
Name:COHEN, BETSY (LCSW)
Entity type:Individual
Prefix:MS
First Name:BETSY
Middle Name:
Last Name:COHEN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1175 MILLER AVE
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94708-1754
Mailing Address - Country:US
Mailing Address - Phone:510-527-1131
Mailing Address - Fax:510-843-6703
Practice Address - Street 1:905 SANTA FE AVE
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:CA
Practice Address - Zip Code:94706-2119
Practice Address - Country:US
Practice Address - Phone:510-527-1131
Practice Address - Fax:510-843-6703
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC40751041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical