Provider Demographics
NPI:1053852913
Name:COOPER MACDIARMID, KRISTEN JOY (LPC)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:JOY
Last Name:COOPER MACDIARMID
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:KRISTEN
Other - Middle Name:JOY
Other - Last Name:COOPER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8523 GRAPEVINE PASS
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78255-2264
Mailing Address - Country:US
Mailing Address - Phone:210-960-3752
Mailing Address - Fax:210-569-7790
Practice Address - Street 1:8523 GRAPEVINE PASS
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78255-2264
Practice Address - Country:US
Practice Address - Phone:210-960-3752
Practice Address - Fax:210-569-7790
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-12
Last Update Date:2021-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX74059101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional