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NPI Code Detail

MEDICARE: MR. DAVID COHEN LCSW, CADC

MEDICARE: MR. DAVID COHEN LCSW, CADC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker76407CA

General Provider Information

NPI Number : 1114110673
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. DAVID COHEN LCSW, CADC
Provider Business Mailing Address
First Line : 1212 N LAKE SHORE DR
Second Line : 17BN
City : CHICAGO
State : IL
Zip : 60610-2371
Country : US
Telephone Number : 312-882-1212
Fax Number :
Provider Business Practice Location Address
First Line : 2644 30TH ST STE 100
Second Line :
City : SANTA MONICA
State : CA
Zip : 90405-3051
Country : US
Telephone Number : 310-314-6200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/19/2007
Last Update Date : 05/13/2020

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