Provider Demographics
NPI:1477216703
Name:COOPER, CINDA L (LSW)
Entity Type:Individual
Prefix:
First Name:CINDA
Middle Name:L
Last Name:COOPER
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 S ROBERTS RD APT D4
Mailing Address - Street 2:
Mailing Address - City:BRYN MAWR
Mailing Address - State:PA
Mailing Address - Zip Code:19010-1309
Mailing Address - Country:US
Mailing Address - Phone:610-608-2801
Mailing Address - Fax:
Practice Address - Street 1:200 S ROBERTS RD APT D4
Practice Address - Street 2:
Practice Address - City:BRYN MAWR
Practice Address - State:PA
Practice Address - Zip Code:19010-1309
Practice Address - Country:US
Practice Address - Phone:610-608-2801
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-13
Last Update Date:2021-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW135157104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker