Provider Demographics
NPI:1548293517
Name:COHEN, CHANTAL (MA)
Entity type:Individual
Prefix:MS
First Name:CHANTAL
Middle Name:
Last Name:COHEN
Suffix:
Gender:F
Credentials:MA
Other - Prefix:MS
Other - First Name:CHANTAL
Other - Middle Name:
Other - Last Name:COHEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMFT
Mailing Address - Street 1:6813 CAPE LISBURNE LOOP
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99504-3959
Mailing Address - Country:US
Mailing Address - Phone:907-346-0252
Mailing Address - Fax:907-202-5456
Practice Address - Street 1:750 W 2ND AVE STE 103
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99501-2167
Practice Address - Country:US
Practice Address - Phone:907-346-0252
Practice Address - Fax:907-202-5452
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-10
Last Update Date:2024-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK201106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist