Provider Demographics
NPI:1871605410
Name:COHEN, JILL (MWS)
Entity type:Individual
Prefix:
First Name:JILL
Middle Name:
Last Name:COHEN
Suffix:
Gender:F
Credentials:MWS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 SIBLEY AVE
Mailing Address - Street 2:
Mailing Address - City:ARDMORE
Mailing Address - State:PA
Mailing Address - Zip Code:19003-2311
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:105 SIBLEY AVENUE
Practice Address - Street 2:HAMILTON AND MIRAGLIA ASSOCIATES
Practice Address - City:ARDMORE
Practice Address - State:PA
Practice Address - Zip Code:19003
Practice Address - Country:US
Practice Address - Phone:215-681-6161
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2008-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0137841041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA2321129000OtherIBC
PA230790000OtherKEYSTONE
PA7204257OtherAETNA