1578557880 NPI number — MARGARET L COHENOUR LISW, LCSW

Table of content: MARGARET L COHENOUR LISW, LCSW (NPI 1578557880)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1578557880 NPI number — MARGARET L COHENOUR LISW, LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
COHENOUR
Provider First Name:
MARGARET
Provider Middle Name:
L
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LISW, LCSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1578557880
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/04/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3131 SANGUINET ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FORT WORTH
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
76107-5336
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
817-255-2636
Provider Business Mailing Address Fax Number:
817-255-2657

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3800 HULEN ST STE 295
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FORT WORTH
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
76107-7276
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
817-255-2636
Provider Business Practice Location Address Fax Number:
817-266-2657
Provider Enumeration Date:
09/01/2005

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  41504 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 104100000X , with the licence number: I-06689 , registered in the state of NM ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)