Provider Demographics
NPI:1689284374
Name:COOPER, LYNN D (PLMHP)
Entity Type:Individual
Prefix:
First Name:LYNN
Middle Name:D
Last Name:COOPER
Suffix:
Gender:F
Credentials:PLMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:407 S CLARK ST
Mailing Address - Street 2:
Mailing Address - City:BASSETT
Mailing Address - State:NE
Mailing Address - Zip Code:68714-6043
Mailing Address - Country:US
Mailing Address - Phone:308-440-9042
Mailing Address - Fax:
Practice Address - Street 1:407 S CLARK
Practice Address - Street 2:
Practice Address - City:BASSETT
Practice Address - State:NE
Practice Address - Zip Code:68714
Practice Address - Country:US
Practice Address - Phone:402-684-2908
Practice Address - Fax:402-913-3454
Is Sole Proprietor?:No
Enumeration Date:2020-08-06
Last Update Date:2023-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE12256101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health