Basic Information
| Provider Information | |||||||||
| NPI: | 1801017140 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | COHEN | ||||||||
| FirstName: | BETH | ||||||||
| MiddleName: | M | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6123 MONTROSE RD | ||||||||
| Address2: | |||||||||
| City: | ROCKVILLE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 208524860 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3018813700 | ||||||||
| FaxNumber: | 3017700901 | ||||||||
| Practice Location | |||||||||
| Address1: | 3018 JAVIER RD | ||||||||
| Address2: | |||||||||
| City: | FAIRFAX | ||||||||
| State: | VA | ||||||||
| PostalCode: | 220314609 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7032049100 | ||||||||
| FaxNumber: | 7032949590 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/02/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 104100000X | 0904006511 | VA | Y | Behavioral Health & Social Service Providers | Social Worker |
No ID Information.