Provider Demographics
NPI:1811367758
Name:WENDY CRANDALL-COHEN, M.A. LMFT
Entity Type:Organization
Organization Name:WENDY CRANDALL-COHEN, M.A. LMFT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:WENDY
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:CRANDALL-COHEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-307-1514
Mailing Address - Street 1:28720 CANWOOD ST
Mailing Address - Street 2:SUITE 204
Mailing Address - City:AGOURA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91301-4521
Mailing Address - Country:US
Mailing Address - Phone:818-307-1514
Mailing Address - Fax:
Practice Address - Street 1:28720 CANWOOD ST
Practice Address - Street 2:SUITE 204
Practice Address - City:AGOURA HILLS
Practice Address - State:CA
Practice Address - Zip Code:91301-4521
Practice Address - Country:US
Practice Address - Phone:818-307-1514
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-05
Last Update Date:2015-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT41754106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty