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Contact Information

MITCHELL R COHEN, SAC-IT, PCTL
500 W SILVER SPRING DR
SUITE 200
GLENDALE, WI53217-5051
 Phone: 414-847-6253
 Fax: 414-501-2361
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Mental Health

101YM0800X
 

Addiction (Substance Use Disorder)

101YA0400X
 

Pastoral

101YP1600X
Indicates primary specialty

NPI Profile & details for MITCHELL R COHEN · (Male)

NPI # 1922448885
Status Active
Credentials SAC-IT, PCTL
Entity Individual
Enumeration date 06/25/2013
Last updated 06/25/2014 - About 12 years ago
Sole proprietor 1 Yes
Identifiers
  • WI License # 16612-130
  • WI License # 1858-226
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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