Provider Demographics
NPI:1659643443
Name:COOPER, MARIAN A (LCSW)
Entity Type:Individual
Prefix:MS
First Name:MARIAN
Middle Name:A
Last Name:COOPER
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 1:13810 CHAMPION FOREST DR STE 150
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77069-1883
Mailing Address - Country:US
Mailing Address - Phone:646-470-1820
Mailing Address - Fax:
Practice Address - Street 1:13810 CHAMPION FOREST DR STE 150
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77069-1883
Practice Address - Country:US
Practice Address - Phone:646-470-1820
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-08
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0844731041C0700X
TX1041931041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical