Provider Demographics
NPI:1851062236
Name:COOPER, VALENTCIA JAMELA
Entity Type:Individual
Prefix:MS
First Name:VALENTCIA
Middle Name:JAMELA
Last Name:COOPER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 52083
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27717-2083
Mailing Address - Country:US
Mailing Address - Phone:252-820-3081
Mailing Address - Fax:
Practice Address - Street 1:225 TALS ROCK WAY STE 6
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27519-1906
Practice Address - Country:US
Practice Address - Phone:984-465-0477
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-24
Last Update Date:2021-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCPO159091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical