Individual
BRADLEY R COHEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW, CAP, ICADC
Contact information
Practice address
5400 SOUTH UNIVERSITY DRIVE, #119, DAVIE, FL 33328
(954) 258-0739
Mailing address
5400 SOUTH UNIVERSITY DRIVE, #119, DAVIE, FL 33328
(954) 258-0739
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
CAP5125
FL
101YA0400X
Addiction (Substance Use Disorder) Counselor
ICADC126606
FL
1041C0700X
Clinical Social Worker
Primary
SW10950
FL
Other
Enumeration date
09/17/2012
Last updated
10/14/2015
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