Provider Demographics
NPI:1871929059
Name:DAVIS-COHEN, SOPHIE SARAH (LCSW)
Entity type:Individual
Prefix:
First Name:SOPHIE
Middle Name:SARAH
Last Name:DAVIS-COHEN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 N ROBERTSON BLVD STE 901
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90048-3112
Mailing Address - Country:US
Mailing Address - Phone:424-256-3965
Mailing Address - Fax:
Practice Address - Street 1:116 N ROBERTSON BLVD STE 901
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90048-3112
Practice Address - Country:US
Practice Address - Phone:424-256-3965
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-19
Last Update Date:2021-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA82466101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA7569OtherMEDICAL