Provider Demographics
NPI:1245421411
Name:HOOPER, AMY ANTHONY (LPC)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:ANTHONY
Last Name:HOOPER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1039 BROWN DR
Mailing Address - Street 2:
Mailing Address - City:WAKE VILLAGE
Mailing Address - State:TX
Mailing Address - Zip Code:75501-8649
Mailing Address - Country:US
Mailing Address - Phone:903-748-4676
Mailing Address - Fax:
Practice Address - Street 1:801 ARKANSAS BLVD
Practice Address - Street 2:
Practice Address - City:TEXARKANA
Practice Address - State:AR
Practice Address - Zip Code:71854-2107
Practice Address - Country:US
Practice Address - Phone:870-774-4673
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-05
Last Update Date:2007-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16627101Y00000X
ARP0505032101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor