Keri S Cohen, LCSW – Clinical Social Worker

Key facts

NPI: 1679523161
Entity type: Individual (NPI type 1)
Primary specialty: Clinical Social Worker 1041C0700X
License: CW012058 (PA)
Practice address: 15 S State St Ste 105
Brownstown, PA 17508-5090
Phone: (717) 945-5064
NPI assigned: May 12, 2006
Sex: Female
Sole proprietor: Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD): No

State licenses

License	State	Type	Specialty
CW012058	PA	MD	Clinical Social Worker

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Clinical Social Worker	1041C0700X	CW012058	PA	Yes

Addresses

Primary practice location

15 S State St Ste 105
Brownstown, PA 17508-5090

Mailing address

1340 Stillwater Rd
Lancaster, PA 17601-5328
Phone (717) 951-4939

Other identifiers

Identifier	Type	State	Issuer
50032634	Other	PA	CAPITAL BLUE CROSS
279820	Other		VALUE OPTIONS

Other names

Keri S Ullman Former name

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Dec 31, 2020.

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609372800000",
    "number": "1679523161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1340 STILLWATER RD",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176015328",
            "telephone_number": "717-951-4939",
            "fax_number": "717-945-5074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 S STATE ST STE 105",
            "city": "BROWNSTOWN",
            "state": "PA",
            "postal_code": "175085090",
            "telephone_number": "717-945-5064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COHEN",
        "first_name": "KERI",
        "middle_name": "S",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-12",
        "last_updated": "2020-12-31",
        "certification_date": "2020-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW012058",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL BLUE CROSS",
            "identifier": "50032634",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "279820",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KERI",
            "last_name": "ULLMAN",
            "middle_name": "S",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Brownstown, PA

All providers in Brownstown, PA · Clinical Social Worker in Pennsylvania

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 31, 2020. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.