Provider Demographics
NPI:1588199038
Name:COHEN, NELI (PSYD)
Entity Type:Individual
Prefix:DR
First Name:NELI
Middle Name:
Last Name:COHEN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4146 GAGE AVE
Mailing Address - Street 2:
Mailing Address - City:LYONS
Mailing Address - State:IL
Mailing Address - Zip Code:60534-1425
Mailing Address - Country:US
Mailing Address - Phone:713-824-6311
Mailing Address - Fax:413-570-4957
Practice Address - Street 1:7300 N CICERO AVE
Practice Address - Street 2:STE 208
Practice Address - City:LINCOLNWOOD
Practice Address - State:IL
Practice Address - Zip Code:60712-1695
Practice Address - Country:US
Practice Address - Phone:413-200-8880
Practice Address - Fax:413-570-4957
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071.009539103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical