=====================================================
General NPI Number Information
=====================================================
NPI Number | 1922869650
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | RACHELLE COHEN PSYCHOTHERAPY, INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/19/2024
-----------------------------------------------------
Last Update Date | 01/19/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 9615 BRIGHTON WAY STE 219
-----------------------------------------------------
City | BEVERLY HILLS
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90210-5118
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 917-282-1436
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 11707 W SUNSET BLVD APT 6
-----------------------------------------------------
City | LOS ANGELES
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90049-2945
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 917-282-1436
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/PSYCHOTHERAPIST
-----------------------------------------------------
Name | RACHELLE SARA COHEN
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 917-282-1436
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QM0850X
-----------------------------------------------------
Taxonomy Name | Adult Mental Health Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------