Provider Demographics
NPI:1871713982
Name:COHEN, ELLEN SUE (LCSW)
Entity type:Individual
Prefix:
First Name:ELLEN
Middle Name:SUE
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 1:4487 LUXEMBURG CT
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33467-5093
Mailing Address - Country:US
Mailing Address - Phone:561-676-8208
Mailing Address - Fax:
Practice Address - Street 1:3199 LAKE WORTH RD
Practice Address - Street 2:
Practice Address - City:PALM SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33461-3652
Practice Address - Country:US
Practice Address - Phone:561-649-6500
Practice Address - Fax:954-497-3857
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-30
Last Update Date:2018-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW7935104100000X, 101YM0800X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical