Provider Demographics
NPI:1689680902
Name:COHEN, CHERYL LYNN (QMHP,CADC)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:LYNN
Last Name:COHEN
Suffix:
Gender:F
Credentials:QMHP,CADC
Other - Prefix:
Other - First Name:CHERYL
Other - Middle Name:LYNN
Other - Last Name:WHITE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2051 KAEN RD
Mailing Address - Street 2:SUITE 367
Mailing Address - City:OREGON CITY
Mailing Address - State:OR
Mailing Address - Zip Code:97045-4035
Mailing Address - Country:US
Mailing Address - Phone:503-742-5937
Mailing Address - Fax:503-742-5304
Practice Address - Street 1:2051 KAEN RD
Practice Address - Street 2:SUITE 367
Practice Address - City:OREGON CITY
Practice Address - State:OR
Practice Address - Zip Code:97045-4035
Practice Address - Country:US
Practice Address - Phone:503-742-5937
Practice Address - Fax:503-742-5304
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2009-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)