Provider Demographics
NPI:1255962791
Name:COHEN DE FISZBEIN, SANDRA (MS, LCPC)
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:
Last Name:COHEN DE FISZBEIN
Suffix:
Gender:F
Credentials:MS, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2125 14TH ST NW APT 308W
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20009-7529
Mailing Address - Country:US
Mailing Address - Phone:240-838-6968
Mailing Address - Fax:
Practice Address - Street 1:4405 E WEST HWY STE 504A
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-4536
Practice Address - Country:US
Practice Address - Phone:240-838-6968
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-03
Last Update Date:2020-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD0160101YP2500X
MDLC0160101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional