Provider Demographics
NPI:1447405212
Name:COOPER-NURSE, JAMES PHILIP (PHD, LMHC)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:PHILIP
Last Name:COOPER-NURSE
Suffix:
Gender:M
Credentials:PHD, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2119 NE 6TH CIR
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98056-4501
Mailing Address - Country:US
Mailing Address - Phone:509-280-1855
Mailing Address - Fax:206-248-8232
Practice Address - Street 1:2119 NE 6TH CIR
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98056-4501
Practice Address - Country:US
Practice Address - Phone:509-280-1855
Practice Address - Fax:206-248-8232
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-20
Last Update Date:2020-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60034520101Y00000X, 101YP2500X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional