Provider Demographics
NPI:1225547847
Name:COOPER, AIMEE ANDERSON (LCMHC)
Entity Type:Individual
Prefix:MS
First Name:AIMEE
Middle Name:ANDERSON
Last Name:COOPER
Suffix:
Gender:F
Credentials:LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 593
Mailing Address - Street 2:
Mailing Address - City:WARRENTON
Mailing Address - State:NC
Mailing Address - Zip Code:27589-0593
Mailing Address - Country:US
Mailing Address - Phone:252-517-9552
Mailing Address - Fax:
Practice Address - Street 1:203 W FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:WARRENTON
Practice Address - State:NC
Practice Address - Zip Code:27589-1935
Practice Address - Country:US
Practice Address - Phone:252-517-9552
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-26
Last Update Date:2023-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC13123101YM0800X
NCA13123101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health