Provider Demographics
NPI:1689076127
Name:COHEN, STEPHEN MICHAEL (LCPC)
Entity Type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:MICHAEL
Last Name:COHEN
Suffix:
Gender:M
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19801 OBSERVATION DR
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20876-4070
Mailing Address - Country:US
Mailing Address - Phone:301-557-6814
Mailing Address - Fax:301-557-5557
Practice Address - Street 1:6040 SOUTHPORT DR
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-1848
Practice Address - Country:US
Practice Address - Phone:240-753-6185
Practice Address - Fax:301-493-6209
Is Sole Proprietor?:No
Enumeration Date:2014-09-16
Last Update Date:2014-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC4410101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional