MEDICARE: STEPHANE H COHEN LPC

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
1	101YP2500X	Professional Counselor	LPC-23474	AZ
2	101YP2500X	Professional Counselor	C6465	OR

General Provider Information

NPI Number	:	1306601471
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHANE H COHEN LPC

Provider Business Mailing Address
First Line	:	17791 NW SYLVANIA CT
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97229-1794
Country	:	US
Telephone Number	:	971-340-7834
Fax Number	:

Provider Business Practice Location Address
First Line	:	17791 NW SYLVANIA CT
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97229-1794
Country	:	US
Telephone Number	:	971-340-7834
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/19/2024
Last Update Date	:	05/14/2026

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