Provider Demographics
NPI:1154874634
Name:COHEN, KAYLA J (MSW, MED)
Entity type:Individual
Prefix:
First Name:KAYLA
Middle Name:J
Last Name:COHEN
Suffix:
Gender:F
Credentials:MSW, MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1417 LOCUST ST
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19102-3829
Mailing Address - Country:US
Mailing Address - Phone:215-564-6388
Mailing Address - Fax:215-564-5360
Practice Address - Street 1:1417 LOCUST ST
Practice Address - Street 2:3RD FLOOR
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19102-3829
Practice Address - Country:US
Practice Address - Phone:215-564-6388
Practice Address - Fax:215-564-5360
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-01
Last Update Date:2016-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW132859104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker