Provider Demographics
NPI:1194311894
Name:COHEN, NANCY JANET (LICSW)
Entity type:Individual
Prefix:MS
First Name:NANCY
Middle Name:JANET
Last Name:COHEN
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:275 BRUSH HILL RD
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:MA
Mailing Address - Zip Code:02186-1011
Mailing Address - Country:US
Mailing Address - Phone:617-696-8887
Mailing Address - Fax:
Practice Address - Street 1:275 BRUSH HILL RD
Practice Address - Street 2:
Practice Address - City:MILTON
Practice Address - State:MA
Practice Address - Zip Code:02186-1011
Practice Address - Country:US
Practice Address - Phone:617-696-8887
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-16
Last Update Date:2020-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA102334104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty