Provider Demographics
NPI:1962766105
Name:COHEN, EMILY BETH (LCSW)
Entity type:Individual
Prefix:MS
First Name:EMILY
Middle Name:BETH
Last Name:COHEN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:820 PRESIDENT ST
Mailing Address - Street 2:1B
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11215-1454
Mailing Address - Country:US
Mailing Address - Phone:718-857-5474
Mailing Address - Fax:
Practice Address - Street 1:820 PRESIDENT ST
Practice Address - Street 2:1B
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215-1454
Practice Address - Country:US
Practice Address - Phone:718-857-5474
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-03
Last Update Date:2012-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY5907586102L00000X
NY66137441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY6613774OtherLCSW
NY5907586OtherPSYCHOANALYST