Provider Demographics
NPI:1497088934
Name:COOPER, MARTY AARON (PHD, LMHC, NCC)
Entity Type:Individual
Prefix:DR
First Name:MARTY
Middle Name:AARON
Last Name:COOPER
Suffix:
Gender:M
Credentials:PHD, LMHC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100A BROADWAY # 331
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11249-6127
Mailing Address - Country:US
Mailing Address - Phone:347-244-7873
Mailing Address - Fax:
Practice Address - Street 1:100 BROADWAY # 331A
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11249-6044
Practice Address - Country:US
Practice Address - Phone:347-244-7873
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-16
Last Update Date:2023-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health