Provider Demographics
NPI:1528492097
Name:COHEN, SARAH A (LPC)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:A
Last Name:COHEN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5441 SW MACADAM AVE
Mailing Address - Street 2:STE. 206
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97239-6106
Mailing Address - Country:US
Mailing Address - Phone:503-205-1744
Mailing Address - Fax:503-222-9989
Practice Address - Street 1:5441 SW MACADAM AVE
Practice Address - Street 2:STE. 206
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97239-6106
Practice Address - Country:US
Practice Address - Phone:503-205-1744
Practice Address - Fax:503-222-9989
Is Sole Proprietor?:No
Enumeration Date:2013-09-02
Last Update Date:2014-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC3449101YM0800X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR164936Medicaid
WA0000WDBCHMedicare Oscar/Certification
OR0000WDBCHMedicare Oscar/Certification