Provider Demographics
NPI:1366563108
Name:COHEN, DANIEL AARON (LCSW,MSW,MDIV,MSJ,BA)
Entity type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:AARON
Last Name:COHEN
Suffix:
Gender:M
Credentials:LCSW,MSW,MDIV,MSJ,BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:98 SANQUIST CIRCLE
Mailing Address - Street 2:98 SANDQUIST CIRCLE
Mailing Address - City:HAMDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06514
Mailing Address - Country:US
Mailing Address - Phone:203-671-8737
Mailing Address - Fax:
Practice Address - Street 1:15 CHURCH ST
Practice Address - Street 2:
Practice Address - City:HAMDEN
Practice Address - State:CT
Practice Address - Zip Code:06514-3435
Practice Address - Country:US
Practice Address - Phone:203-671-8737
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-02
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0072281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT13802851OtherCAQH
CT008037039Medicaid