Provider Demographics
NPI:1811588213
Name:COOPER, ERIN HALEY (LMSW)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:HALEY
Last Name:COOPER
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:HALEY
Other - Last Name:MCELEARNEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:240 NORTH AVE
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30601-2244
Mailing Address - Country:US
Mailing Address - Phone:706-224-0532
Mailing Address - Fax:
Practice Address - Street 1:240 NORTH AVE
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30601-2244
Practice Address - Country:US
Practice Address - Phone:706-224-0532
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-28
Last Update Date:2021-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMSW009283104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker