Provider Demographics
NPI:1417141474
Name:COOPER RAPPAPORT, SUSAN A (LCSW)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:A
Last Name:COOPER RAPPAPORT
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:84 HOSPITAL AVE
Mailing Address - Street 2:
Mailing Address - City:DANBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06810-6021
Mailing Address - Country:US
Mailing Address - Phone:203-792-6060
Mailing Address - Fax:203-794-9556
Practice Address - Street 1:84 HOSPITAL AVE
Practice Address - Street 2:
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06810-6021
Practice Address - Country:US
Practice Address - Phone:203-792-6060
Practice Address - Fax:203-794-9556
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-04
Last Update Date:2007-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0045751041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical