MEDICARE: KAREN ELIZABETH COHEN M.S. ,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	101YM0800X	Mental Health Counselor		IL
2	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1275056780
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAREN ELIZABETH COHEN M.S. ,LPC

Provider Business Mailing Address
First Line	:	1331 S ESTATE LN
Second Line	:
City	:	LAKE FOREST
State	:	IL
Zip	:	60045-3668
Country	:	US
Telephone Number	:	847-987-3213
Fax Number	:

Provider Business Practice Location Address
First Line	:	1331 S. ESTATE LANE
Second Line	:
City	:	LAKE FOREST
State	:	IL
Zip	:	60045
Country	:	US
Telephone Number	:	847-987-3213
Fax Number	:

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

Provider Enumeration Date	:	07/18/2017
Last Update Date	:	07/25/2017

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