Provider Demographics
NPI:1104127935
Name:COHRS, COREY M (PHD)
Entity type:Individual
Prefix:DR
First Name:COREY
Middle Name:M
Last Name:COHRS
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:DR
Other - First Name:COREY
Other - Middle Name:M
Other - Last Name:COHRS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:15434 WINDSOR DR
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68154-4104
Mailing Address - Country:US
Mailing Address - Phone:727-420-7461
Mailing Address - Fax:
Practice Address - Street 1:13322 I ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68137-1111
Practice Address - Country:US
Practice Address - Phone:402-230-5861
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-10
Last Update Date:2017-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1585101YM0800X
IA085646101YM0800X
103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health