Provider Demographics
NPI:1275701021
Name:COOPER, LAWRENCE WILLIAM
Entity Type:Individual
Prefix:MR
First Name:LAWRENCE
Middle Name:WILLIAM
Last Name:COOPER
Suffix:
Gender:M
Credentials:
Other - Prefix:MR
Other - First Name:LAWRENCE
Other - Middle Name:WILLIAM
Other - Last Name:COOPER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:SOCIAL WORKER
Mailing Address - Street 1:53 EAGLE ST
Mailing Address - Street 2:
Mailing Address - City:PITTSFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01201-4714
Mailing Address - Country:US
Mailing Address - Phone:413-236-5656
Mailing Address - Fax:413-499-6572
Practice Address - Street 1:53 EAGLE ST
Practice Address - Street 2:
Practice Address - City:PITTSFIELD
Practice Address - State:MA
Practice Address - Zip Code:01201-4714
Practice Address - Country:US
Practice Address - Phone:413-236-5656
Practice Address - Fax:413-499-6572
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-14
Last Update Date:2008-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker