Provider Demographics
NPI:1346095007
Name:JANE R. COOPER COUNSELING & PSYCHOTHERAPY, PLLC
Entity Type:Organization
Organization Name:JANE R. COOPER COUNSELING & PSYCHOTHERAPY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PROFESSIONAL COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:JANE
Authorized Official - Middle Name:ROBERTA
Authorized Official - Last Name:COOPER
Authorized Official - Suffix:
Authorized Official - Credentials:MED, LPC
Authorized Official - Phone:860-638-9966
Mailing Address - Street 1:302 FOUNDERS RD
Mailing Address - Street 2:
Mailing Address - City:GLASTONBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06033-3210
Mailing Address - Country:US
Mailing Address - Phone:860-638-9966
Mailing Address - Fax:
Practice Address - Street 1:302 FOUNDERS RD
Practice Address - Street 2:
Practice Address - City:GLASTONBURY
Practice Address - State:CT
Practice Address - Zip Code:06033-3210
Practice Address - Country:US
Practice Address - Phone:860-638-9966
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-17
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health