Provider Demographics
NPI:1225892326
Name:COHN, MARLEY (LMFT)
Entity Type:Individual
Prefix:
First Name:MARLEY
Middle Name:
Last Name:COHN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21026 SUSAN CAROLE DR
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARITA
Mailing Address - State:CA
Mailing Address - Zip Code:91350-1943
Mailing Address - Country:US
Mailing Address - Phone:661-212-0994
Mailing Address - Fax:
Practice Address - Street 1:12407 WAGNER ST APT 106
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90066-6874
Practice Address - Country:US
Practice Address - Phone:661-212-0994
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-08
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA144655106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist