Provider Demographics
NPI:1346452323
Name:COOPER, THOMAS ANDREW (LPCC-S)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:ANDREW
Last Name:COOPER
Suffix:
Gender:M
Credentials:LPCC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15200 MADISON AVE
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44107-4019
Mailing Address - Country:US
Mailing Address - Phone:440-260-6101
Mailing Address - Fax:440-260-8390
Practice Address - Street 1:15200 MADISON AVE
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:OH
Practice Address - Zip Code:44107-4019
Practice Address - Country:US
Practice Address - Phone:440-260-6101
Practice Address - Fax:440-260-8390
Is Sole Proprietor?:No
Enumeration Date:2007-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE0002631101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health