Provider Demographics
NPI:1376253807
Name:COOPER, NAKIA MONET' (LLPC)
Entity Type:Individual
Prefix:MRS
First Name:NAKIA
Middle Name:MONET'
Last Name:COOPER
Suffix:
Gender:F
Credentials:LLPC
Other - Prefix:
Other - First Name:NAKIA
Other - Middle Name:MONET'
Other - Last Name:VANCE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3611 HENRY ST
Mailing Address - Street 2:
Mailing Address - City:NORTON SHORES
Mailing Address - State:MI
Mailing Address - Zip Code:49441-4705
Mailing Address - Country:US
Mailing Address - Phone:231-237-8898
Mailing Address - Fax:
Practice Address - Street 1:3611 HENRY ST
Practice Address - Street 2:
Practice Address - City:NORTON SHORES
Practice Address - State:MI
Practice Address - Zip Code:49441-4705
Practice Address - Country:US
Practice Address - Phone:231-237-8898
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-23
Last Update Date:2022-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty