MEDICARE: CHANTEL COHEN LCSW

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	101YM0800X	Mental Health Counselor	CSW006036	GA

General Provider Information

NPI Number	:	1992507974
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHANTEL COHEN LCSW

Provider Business Mailing Address
First Line	:	550 PHARR RD NE STE 205
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30305-3433
Country	:	US
Telephone Number	:	470-296-3090
Fax Number	:

Provider Business Practice Location Address
First Line	:	550 PHARR RD NE STE 205
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30305-3433
Country	:	US
Telephone Number	:	470-296-3090
Fax Number	:

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

Provider Enumeration Date	:	03/27/2025
Last Update Date	:	03/27/2025

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Directions to “ CHANTEL COHEN LCSW” Practice Location

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