Provider Demographics
NPI:1508129354
Name:COHEN, DAWNELL LINN (LAC 510)
Entity Type:Individual
Prefix:
First Name:DAWNELL
Middle Name:LINN
Last Name:COHEN
Suffix:
Gender:F
Credentials:LAC 510
Other - Prefix:
Other - First Name:DAWNELL
Other - Middle Name:LINN
Other - Last Name:COHEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LAC 510
Mailing Address - Street 1:924 S. WASHINGTON
Mailing Address - Street 2:
Mailing Address - City:WELLINGTON
Mailing Address - State:KS
Mailing Address - Zip Code:67152
Mailing Address - Country:US
Mailing Address - Phone:316-461-0058
Mailing Address - Fax:660-665-3989
Practice Address - Street 1:924 S. WASHINGTON
Practice Address - Street 2:
Practice Address - City:WELLINGTON
Practice Address - State:KS
Practice Address - Zip Code:67152
Practice Address - Country:US
Practice Address - Phone:316-461-0058
Practice Address - Fax:660-665-3989
Is Sole Proprietor?:No
Enumeration Date:2012-06-18
Last Update Date:2021-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS510101YA0400X
KSLAC510101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)