Individual provider Active NPI

Herbert Steven Cohen, ED.D

  • Clinical Psychologist
  • Stamford, CT
National Provider Identifier
1720357528
Registry record updated Dec 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
918 Issued in CT
Practice address
106 Gun Club Rd
Stamford, CT 06903-1024
Phone
(203) 968-0469
NPI assigned
Dec 22, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 22, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 918 CT Primary

Addresses

Primary practice location

106 Gun Club Rd
Stamford, CT 06903-1024

Mailing address

106 Gun Club Rd
Stamford, CT 06903-1024
Phone (203) 968-0469

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040225000089 CT Practitioner - Clinical Psychologist 0547156721 Practice locations: Stamford, CT

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
918CTMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1324512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1324512000000",
    "number": "1720357528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 GUN CLUB RD",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069031024",
            "telephone_number": "203-968-0469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 GUN CLUB RD",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069031024",
            "telephone_number": "203-968-0469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COHEN",
        "first_name": "HERBERT",
        "middle_name": "STEVEN",
        "name_prefix": "Dr.",
        "credential": "ED.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-12-22",
        "last_updated": "2011-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CT",
            "license": "918",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stamford, CT

Sources for this page

Verify at the official NPI Registry.