Provider Demographics
NPI:1255410627
Name:COHEN-STEIN, ALISA MIRIAM (LCSW)
Entity type:Individual
Prefix:MS
First Name:ALISA
Middle Name:MIRIAM
Last Name:COHEN-STEIN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5225 OLD ORCHARD RD
Mailing Address - Street 2:27A
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60077-4405
Mailing Address - Country:US
Mailing Address - Phone:847-673-0511
Mailing Address - Fax:847-673-0511
Practice Address - Street 1:5225 OLD ORCHARD RD
Practice Address - Street 2:27A
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60077-4405
Practice Address - Country:US
Practice Address - Phone:847-673-0511
Practice Address - Fax:847-673-0511
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-04
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490007231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1671043OtherLCSW BLUE CROSS
IL1671043OtherLCSW BLUE CROSS