Healthcare Provider Details

I. General information

NPI: 1215850623
Provider Name (Legal Business Name): JASON ISRAEL KOHAVI LMHC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/03/2026
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 BROADWAY RM 502
NEW YORK NY
10038-4380
US

IV. Provider business mailing address

667 STONELEIGH AVE STE 202
CARMEL NY
10512-2455
US

V. Phone/Fax

Practice location:
  • Phone: 845-279-5908
  • Fax: 845-622-3636
Mailing address:
  • Phone: 845-279-5908
  • Fax: 845-622-5055

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number018245
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: