Individual provider Active NPI

Jeff Cohen, CASAC

  • Addiction (Substance Use Disorder) Counselor
  • New York, NY
National Provider Identifier
1356589329
Registry record updated Jan 29, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
11633 Issued in NY
Practice address
420 E 111TH St
Apt 613
New York, NY 10029-3042
Phone
(917) 434-6063
Fax
(718) 503-7751
NPI assigned
Jan 29, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 29, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 11633 NY Primary

Addresses

Primary practice location

420 E 111TH St
Apt 613
New York, NY 10029-3042

Mailing address

420 E 111TH St
Apt 613
New York, NY 10029-3042
Phone (917) 434-6063

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
11633NYMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1233187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233187200000",
    "number": "1356589329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 E 111TH ST",
            "address_2": "APT 613",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100293042",
            "telephone_number": "917-434-6063",
            "fax_number": "718-503-7751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 E 111TH ST",
            "address_2": "APT 613",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100293042",
            "telephone_number": "917-434-6063",
            "fax_number": "718-503-7751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COHEN",
        "first_name": "JEFF",
        "credential": "CASAC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-01-29",
        "last_updated": "2009-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NY",
            "license": "11633",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2009; 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.