Provider Demographics
NPI:1528681053
Name:COHEN, LYNN FAUST (MA, MSSW, LCSW)
Entity type:Individual
Prefix:
First Name:LYNN
Middle Name:FAUST
Last Name:COHEN
Suffix:
Gender:F
Credentials:MA, MSSW, LCSW
Other - Prefix:
Other - First Name:LYNN
Other - Middle Name:
Other - Last Name:FAUST COHEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA, MSSW, LCSW
Mailing Address - Street 1:9425 RAVEN HOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-8605
Mailing Address - Country:US
Mailing Address - Phone:615-668-3060
Mailing Address - Fax:
Practice Address - Street 1:9425 RAVEN HOLLOW RD
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-8605
Practice Address - Country:US
Practice Address - Phone:615-668-3060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-19
Last Update Date:2020-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN00000039961041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty