Individual provider Active NPI

Madeline Burgen Cohen, LCSW

  • Clinical Social Worker
  • Tucson, AZ
National Provider Identifier
1053555771
Registry record updated Apr 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW-1919 Issued in AZ
Practice address
5215 N, Sabino Canyon Rd.
Tucson, AZ 85750-6435
Phone
(520) 243-9287
NPI assigned
Apr 24, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 13, 2011

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 LCSW-1919 AZ Primary

Addresses

Primary practice location

5215 N, Sabino Canyon Rd.
Tucson, AZ 85750-6435

Mailing address

7775 E. Windriver Dr.
Tucson, AZ 85750-7017
Phone (520) 243-9287

Other identifiers 1

IdentifierTypeStateIssuer
744468MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW-1919AZMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1240531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302652800000",
    "number": "1053555771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7775 E. WINDRIVER DR.",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857507017",
            "telephone_number": "520-243-9287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5215 N, SABINO CANYON RD.",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857506435",
            "telephone_number": "520-243-9287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COHEN",
        "first_name": "MADELINE",
        "middle_name": "BURGEN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-04-24",
        "last_updated": "2011-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AZ",
            "license": "LCSW-1919",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "744468",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.