Provider Demographics
NPI:1568801587
Name:COHENS, ROOSEVELT (LPC)
Entity Type:Individual
Prefix:DR
First Name:ROOSEVELT
Middle Name:
Last Name:COHENS
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3909 SNOW FAWN AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89084-4960
Mailing Address - Country:US
Mailing Address - Phone:202-373-2853
Mailing Address - Fax:202-506-3712
Practice Address - Street 1:3909 SNOW FAWN AVE
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89084-4960
Practice Address - Country:US
Practice Address - Phone:202-373-2853
Practice Address - Fax:202-506-3711
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-24
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPRC985101YM0800X
DCLC500804191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health