Provider Demographics
NPI:1326582453
Name:COOPER MENTAL HEALTH COUNSELING, PLLC
Entity Type:Organization
Organization Name:COOPER MENTAL HEALTH COUNSELING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARTY
Authorized Official - Middle Name:AARON
Authorized Official - Last Name:COOPER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:347-244-7873
Mailing Address - Street 1:226 W 26TH ST # 804
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-6700
Mailing Address - Country:US
Mailing Address - Phone:347-244-8783
Mailing Address - Fax:
Practice Address - Street 1:226 W 26TH ST # 804
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-6700
Practice Address - Country:US
Practice Address - Phone:347-244-8783
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-08
Last Update Date:2016-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY021944103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Multi-Specialty