Provider Demographics
NPI:1710254735
Name:COOPER-MOLINERO, ANITA K (LMSW, PHD)
Entity Type:Individual
Prefix:MS
First Name:ANITA
Middle Name:K
Last Name:COOPER-MOLINERO
Suffix:
Gender:F
Credentials:LMSW, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:207 W HIGH TER
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14619-1836
Mailing Address - Country:US
Mailing Address - Phone:585-729-6859
Mailing Address - Fax:
Practice Address - Street 1:207 W HIGH TER
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14619-1836
Practice Address - Country:US
Practice Address - Phone:585-729-6859
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-18
Last Update Date:2015-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY075472-1104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker