Active NPI
Mitchell R Cohen, SAC-IT, PCTL
- Mental Health Counselor
- Glendale, WI
National Provider Identifier
1922448885
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 1858-226
- Practice address
- 500 W Silver Spring Dr
Suite 200
Glendale, WI 53217-5051 - Phone
- (414) 847-6253
- Fax
- (414) 501-2361
- NPI assigned
- Jun 25, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 16612-130 | WI | |
| Mental Health Counselor | 101YM0800X | 1858-226 | WI | Primary |
| Pastoral Counselor | 101YP1600X |
Addresses
Primary practice location
500 W Silver Spring Dr
Suite 200
Glendale, WI 53217-5051
Mailing address
500 W. Silver Spring Rd
Suite 200
Glendale, WI 53217-4300
Phone (414) 847-6253
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16612-130 | WI | MD | Addiction (Substance Use Disorder) Counselor |
| 1858-226 | WI | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1372118400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1403654400000",
"number": "1922448885",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "500 W. SILVER SPRING RD",
"address_2": "SUITE 200",
"city": "GLENDALE",
"state": "WI",
"postal_code": "532174300",
"telephone_number": "414-847-6253",
"fax_number": "414-501-2361"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 W SILVER SPRING DR",
"address_2": "SUITE 200",
"city": "GLENDALE",
"state": "WI",
"postal_code": "532175051",
"telephone_number": "414-847-6253",
"fax_number": "414-501-2361"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COHEN",
"first_name": "MITCHELL",
"middle_name": "R",
"name_prefix": "Mr.",
"credential": "SAC-IT, PCTL",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-06-25",
"last_updated": "2014-06-25",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "WI",
"license": "16612-130",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "WI",
"license": "1858-226",
"primary": true
},
{
"code": "101YP1600X",
"taxonomy_group": "",
"desc": "Counselor, Pastoral",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Glendale, WI
- Clear Direction Psychological Services, Inc.
- Clearview Medical Imaging, LLC
- Nakita Dominique Cleveland Hickles, LPC
- Mariah Cloutier, PT, DPT
- Elizabeth Laura Cloyd, MS CCC SLP
- Susan E Cohen, LCSW
- Maelynn D Colinco, MD
- Collaborative Psychotherapy, LLC
- Columbia St. Mary'S Hospital Milwaukee, Inc
- Columbia St. Mary'S Hospital Milwaukee, Inc
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.