Provider Demographics
NPI:1912212101
Name:COHEN, JENNIFER COURTNEY (LMFT85173)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:COURTNEY
Last Name:COHEN
Suffix:
Gender:F
Credentials:LMFT85173
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:404 E 1ST ST # 406
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90802-4903
Mailing Address - Country:US
Mailing Address - Phone:562-704-6590
Mailing Address - Fax:
Practice Address - Street 1:121 LINDEN AVE # B110
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90802-4990
Practice Address - Country:US
Practice Address - Phone:562-704-6590
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-11
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist