Provider Demographics
NPI:1235348095
Name:COOPER, CARMEN MUNIZ (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:CARMEN
Middle Name:MUNIZ
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 1:545 SAW MILL RIVER ROAD
Mailing Address - Street 2:SUITE 3A
Mailing Address - City:ARDSLEY
Mailing Address - State:NY
Mailing Address - Zip Code:10502
Mailing Address - Country:US
Mailing Address - Phone:914-693-4521
Mailing Address - Fax:914-693-4802
Practice Address - Street 1:545 SAW MILL RIVER ROAD
Practice Address - Street 2:SUITE 3A
Practice Address - City:ARDSLEY
Practice Address - State:NY
Practice Address - Zip Code:10502
Practice Address - Country:US
Practice Address - Phone:914-693-4521
Practice Address - Fax:914-693-4802
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY072649104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker