Provider Demographics
NPI:1619218583
Name:COOPER, SANDRA (LPCMH)
Entity Type:Individual
Prefix:MS
First Name:SANDRA
Middle Name:
Last Name:COOPER
Suffix:
Gender:F
Credentials:LPCMH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 ALDRIDGE CT
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19702-2154
Mailing Address - Country:US
Mailing Address - Phone:302-379-2666
Mailing Address - Fax:
Practice Address - Street 1:2501 MILLTOWN RD
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19808-3909
Practice Address - Country:US
Practice Address - Phone:302-738-4539
Practice Address - Fax:302-266-0881
Is Sole Proprietor?:No
Enumeration Date:2013-03-02
Last Update Date:2013-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE0000629101YP1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral