MEDICARE: DOUGAS A. COHEN MA, LMFT

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	101YA0400X	Addiction (Substance Use Disorder) Counselor	LMFT46915	CA
2	103K00000X	Behavior Analyst
3	106H00000X	Marriage & Family Therapist	MFC 46915	CA

General Provider Information

NPI Number	:	1285878454
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DOUGAS A. COHEN MA, LMFT

Provider Business Mailing Address
First Line	:	8455 FOUNTAIN AVE UNIT 623
Second Line	:
City	:	WEST HOLLYWOOD
State	:	CA
Zip	:	90069-2547
Country	:	US
Telephone Number	:	805-216-0974
Fax Number	:	323-654-2227

Provider Business Practice Location Address
First Line	:	8455 FOUNTAIN AVE UNIT 623
Second Line	:
City	:	WEST HOLLYWOOD
State	:	CA
Zip	:	90069-2547
Country	:	US
Telephone Number	:	805-216-0974
Fax Number	:	323-654-2227

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

Provider Enumeration Date	:	05/01/2009
Last Update Date	:	03/21/2023

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