Provider Demographics
NPI:1750657813
Name:COHN, BRIAN (MED, BCBA)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:
Last Name:COHN
Suffix:
Gender:M
Credentials:MED, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1626 S KLINE CT
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80232-6337
Mailing Address - Country:US
Mailing Address - Phone:913-522-5178
Mailing Address - Fax:
Practice Address - Street 1:3425 BLAKE ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80205-2406
Practice Address - Country:US
Practice Address - Phone:720-419-2187
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-22
Last Update Date:2019-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1-14-9702103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst