Healthcare Provider Details

I. General information

NPI: 1558965996
Provider Name (Legal Business Name): NETA COHEN MA, LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/25/2020
Last Update Date: 11/01/2022
Certification Date: 11/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2366 EASTLAKE AVE E STE 335
SEATTLE WA
98102-3399
US

IV. Provider business mailing address

2366 EASTLAKE AVE E STE 335
SEATTLE WA
98102-3399
US

V. Phone/Fax

Practice location:
  • Phone: 206-639-2880
  • Fax: 206-639-2883
Mailing address:
  • Phone: 206-639-2880
  • Fax: 206-639-2883

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMC61032145
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLH61156085
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: