Active NPI
Martha Susan Cohen, PH.D.
- Clinical Psychologist
- Minneapolis, MN
National Provider Identifier
1497925911
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- LP1749
- Practice address
- 416 E Hennepin Ave
Ste 107
Minneapolis, MN 55414-1006 - Phone
- (612) 379-5360
- Fax
- (612) 379-5360
- NPI assigned
- Mar 12, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | LP1749 | MN | Primary |
Addresses
Primary practice location
416 E Hennepin Ave
Ste 107
Minneapolis, MN 55414-1006
Mailing address
416 E Hennepin Ave
Ste 107
Minneapolis, MN 55414-1006
Phone (612) 379-5360
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02849CO | Other | MN | BLUE CROSS BLUE SHIELD |
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LP1749 | MN | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1205280000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1205280000000",
"number": "1497925911",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "416 E HENNEPIN AVE",
"address_2": "STE 107",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554141006",
"telephone_number": "612-379-5360",
"fax_number": "612-379-5360"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "416 E HENNEPIN AVE",
"address_2": "STE 107",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554141006",
"telephone_number": "612-379-5360",
"fax_number": "612-379-5360"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COHEN",
"first_name": "MARTHA",
"middle_name": "SUSAN",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-03-12",
"last_updated": "2008-03-12",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MN",
"license": "LP1749",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "02849CO",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Minneapolis, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.