Individual provider Active NPI

Craig Mitchell Cohen, PH.D., L.C.S.W.

  • Clinical Social Worker
  • Philadelphia, PA
National Provider Identifier
1013120229
Registry record updated Dec 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CW015112 Issued in PA
Practice address
1601 Walnut St Ste 406
Philadelphia, PA 19102-2903
Phone
(215) 779-5803
NPI assigned
May 7, 2007
Last updated
Dec 5, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 5, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X CW015112 PA Primary

Addresses

Primary practice location

1601 Walnut St Ste 406
Philadelphia, PA 19102-2903

Mailing address

108 N Woodstock St
Philadelphia, PA 19103-1111
Phone (215) 779-5803

Other practice location 1

1601 Walnut St
#403
Philadelphia, PA 19102-2944
Phone (215) 779-5803

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050927000031 PA Practitioner - Clinical Social Worker 0749214971 Practice locations: Philadelphia, PA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1601 Walnut St
Philadelphia, PA 19102-2903
Phone (215) 779-5803

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
CW015112PAMDClinical Social Worker
061982NYMDPharmacist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1178496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670198400000",
    "number": "1013120229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 N WOODSTOCK ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191031111",
            "telephone_number": "215-779-5803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 WALNUT ST STE 406",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191022903",
            "telephone_number": "215-779-5803"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1601 Walnut St",
            "address_2": "#403",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191022944",
            "country_code": "US",
            "telephone_number": "215-779-5803",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COHEN",
        "first_name": "CRAIG",
        "middle_name": "MITCHELL",
        "name_prefix": "Dr.",
        "credential": "PH.D., L.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-07",
        "last_updated": "2022-12-05",
        "certification_date": "2022-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW015112",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.