Provider Demographics
NPI:1124498076
Name:COHEN, JOSHUA M (LICSW, MT-BC)
Entity type:Individual
Prefix:MR
First Name:JOSHUA
Middle Name:M
Last Name:COHEN
Suffix:
Gender:M
Credentials:LICSW, MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 BURRILL ST
Mailing Address - Street 2:
Mailing Address - City:WALPOLE
Mailing Address - State:MA
Mailing Address - Zip Code:02081-3830
Mailing Address - Country:US
Mailing Address - Phone:774-300-9098
Mailing Address - Fax:
Practice Address - Street 1:34 SCHOOL ST
Practice Address - Street 2:SUITE #104
Practice Address - City:FOXBORO
Practice Address - State:MA
Practice Address - Zip Code:02035-2339
Practice Address - Country:US
Practice Address - Phone:508-543-3411
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-05
Last Update Date:2015-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1192041041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical