Provider Demographics
NPI:1215194899
Name:COHEN, STEVEN WADE (MFCC)
Entity Type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:WADE
Last Name:COHEN
Suffix:
Gender:M
Credentials:MFCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8192 REDFORD LN
Mailing Address - Street 2:
Mailing Address - City:LA PALMA
Mailing Address - State:CA
Mailing Address - Zip Code:90623-1963
Mailing Address - Country:US
Mailing Address - Phone:714-826-7349
Mailing Address - Fax:
Practice Address - Street 1:9405 FLOWER ST
Practice Address - Street 2:
Practice Address - City:BELLFLOWER
Practice Address - State:CA
Practice Address - Zip Code:90706-5705
Practice Address - Country:US
Practice Address - Phone:714-826-7349
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-21
Last Update Date:2008-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC29802106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist