Provider Demographics
NPI:1528149879
Name:KOHEN, HARRIET ADELE (MSW)
Entity type:Individual
Prefix:
First Name:HARRIET
Middle Name:ADELE
Last Name:KOHEN
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10505 WAYZATA BLVD
Mailing Address - Street 2:SUITE #200
Mailing Address - City:MINNETONKA
Mailing Address - State:MN
Mailing Address - Zip Code:55305-1502
Mailing Address - Country:US
Mailing Address - Phone:763-545-8489
Mailing Address - Fax:
Practice Address - Street 1:10505 WAYZATA BLVD
Practice Address - Street 2:SUITE #200
Practice Address - City:MINNETONKA
Practice Address - State:MN
Practice Address - Zip Code:55305-1502
Practice Address - Country:US
Practice Address - Phone:763-545-8489
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2013-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN144061041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN88G08KOOtherBLUE CROSS BLUE SHIELD