Provider Demographics
NPI:1003559964
Name:COOPER, ANN (LMSW)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:
Last Name:COOPER
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 W JACKSON AVE APT 216
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37902-1251
Mailing Address - Country:US
Mailing Address - Phone:423-361-3045
Mailing Address - Fax:
Practice Address - Street 1:118 W JACKSON AVE APT 216
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37902-1251
Practice Address - Country:US
Practice Address - Phone:423-361-3045
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-19
Last Update Date:2022-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN9713104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker