Provider Demographics
NPI:1851088314
Name:AHRA KO LCSW COGNITHRIVE CORPORATION
Entity Type:Organization
Organization Name:AHRA KO LCSW COGNITHRIVE CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:AHRA
Authorized Official - Middle Name:
Authorized Official - Last Name:KO
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:213-761-5540
Mailing Address - Street 1:3980 WILSHIRE BLVD SUITE 341
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90010-4217
Mailing Address - Country:US
Mailing Address - Phone:267-467-7563
Mailing Address - Fax:
Practice Address - Street 1:3980 WILSHIRE BLVD SUITE 341
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90010-4217
Practice Address - Country:US
Practice Address - Phone:267-467-7563
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-24
Last Update Date:2023-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty