Michelle M Cohen, CRNP
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Washington, PA
NPI 1124497995 · NPPES record last updated Jul 23, 2021
Key facts
- NPI
- 1124497995
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- SP023180 (PA)
- Practice address
- 37 Highland Ave
Washington, PA 15301-4062 - Phone
- (724) 223-1067
- Fax
- (724) 223-1088
- NPI assigned
- Sep 22, 2015
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 28
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Centerville Clinics, Inc.
Practice addresses (Care Compare)
190 Bonar Ave
Waynesburg, PA 15370-1604
Phone (724) 627-8156
37 Highland Ave
Washington, PA 15301-4062
Phone (724) 223-1067
Hospital & facility affiliations
- Washington Hospital, the
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20151118002232 | PA | Practitioner - Nurse Practitioner | 6103126453 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SP015236 | PA | MD | Family Nurse Practitioner |
| SP023180 | PA | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Centerville Clinics, Inc. | Current |
Accepting new patients | |
| Centerville Clinics, Inc. | Current | Accepting new patients | |
| Centerville Clinics, Inc | Current |
Accepting new patients | |
| Centerville Clinics, Inc. | Current | Accepting new patients | |
| Centerville Clinics, Inc. | Current | Accepting new patients | |
| Centerville Clinics, Inc. | Current | Accepting new patients | |
| Centerville Clinics, Inc, | Past | Accepting new patients |
Locations
1070 Old National Pike
Fredericktown, PA 15333
37 Highland Ave
Washington, PA 15301
Phone (724) 223-1067
190 Bonar Ave
Waynesburg, PA 15370
Phone (724) 627-8156
Interoperability endpoints
- michelle.cohen.1@33484.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | SP015236 | PA | |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | SP023180 | PA | Yes |
Addresses
Primary practice location
37 Highland Ave
Washington, PA 15301-4062
Mailing address
1070 Old National Pike
Fredericktown, PA 15333-2114
Phone (724) 632-6801
Other practice location 1
190 Bonar Ave
Waynesburg, PA 15370-1604
Phone (724) 627-8156
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 014582 | Other | PA | HIGHMARK BLUE SHIELD |
| 1007288440104 | Medicaid | PA |
Other providers in Washington, PA
- Annette Marice Clemente
- Mark Antonio Clemente
- Clinical Hand Rehabilitation, Inc
- Jacqueline Mae Clous
- CMB Washington LLC
- Craig W Colditz
- Brenda S Cole
- Karen J. Coleman
- Sarah L Collins
- Tricia Collins
All providers in Washington, PA · Psychiatric/Mental Health Nurse Practitioner in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 23, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.