Individual provider Active NPI

Deborah Ruth Cohen, M.S.W.

  • Clinical Social Worker
  • Lawrenceville, GA
National Provider Identifier
1093805129
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
290 Issued in GA
Practice address
575 Professional Dr Ste 510
Lawrenceville, GA 30045-3336
Phone
(770) 246-7611
Fax
(770) 513-7986
NPI assigned
Oct 12, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 290 GA Primary

Addresses

Primary practice location

575 Professional Dr Ste 510
Lawrenceville, GA 30045-3336

Mailing address

575 Professional Dr Ste 510
Lawrenceville, GA 30045-3336
Phone (770) 246-7611

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20091118000020 GA Practitioner - Clinical Social Worker 2769520436 Practice locations: Lawrenceville, GA; Norcross, GA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
University of Maryland School of Medicine, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

Norcross, GA 30071
Phone (678) 522-6582

575 Professional Dr
Suite 510
Lawrenceville, GA 30046-3336
Phone (770) 246-7611

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
290GAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1093805129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "575 PROFESSIONAL DR STE 510",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300453336",
            "telephone_number": "770-246-7611",
            "fax_number": "770-513-7986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "575 PROFESSIONAL DR STE 510",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300453336",
            "telephone_number": "770-246-7611",
            "fax_number": "770-513-7986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COHEN",
        "first_name": "DEBORAH",
        "middle_name": "RUTH",
        "name_prefix": "Ms.",
        "credential": "M.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "290",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceville, GA

Sources for this page

Verify at the official NPI Registry.