Ellia Cohen, LICSW

Individual provider Active NPI Clinical Social Worker · Berlin, VT

NPI 1124540075 · NPPES record last updated Jul 12, 2017

Key facts

NPI
1124540075
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
089.0111626 (VT)
Practice address
174 Hospital Loop
Berlin, VT 05602-9105
Phone
(802) 479-4083
Fax
(802) 476-1476
NPI assigned
Jul 12, 2017
Sex
Female
Sole proprietor
No

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
Yes

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 089.0111626 VT Yes

Addresses

Primary practice location

174 Hospital Loop
Berlin, VT 05602-9105

Mailing address

PO Box 647
Montpelier, VT 05601-0647
Phone (802) 479-4083

Other providers in Berlin, VT

All providers in Berlin, VT · Clinical Social Worker in Vermont

Sources for this page

Verify at the official NPI Registry.