Provider Demographics
NPI:1447318795
Name:COHEN, ANDREA DORIA (LMSW)
Entity type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:DORIA
Last Name:COHEN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:72 LAUREL HILL DR
Mailing Address - Street 2:
Mailing Address - City:VALLEY STREAM
Mailing Address - State:NY
Mailing Address - Zip Code:11581-2549
Mailing Address - Country:US
Mailing Address - Phone:516-791-2437
Mailing Address - Fax:516-791-2437
Practice Address - Street 1:72 LAUREL HILL DR
Practice Address - Street 2:
Practice Address - City:VALLEY STREAM
Practice Address - State:NY
Practice Address - Zip Code:11581-2549
Practice Address - Country:US
Practice Address - Phone:516-791-2437
Practice Address - Fax:516-791-2437
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY032870-1104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker