Provider Demographics
NPI:1932695467
Name:COOPER, CHLOE KRISTINA (LPC)
Entity Type:Individual
Prefix:
First Name:CHLOE
Middle Name:KRISTINA
Last Name:COOPER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25220 FARADAY RD
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN
Mailing Address - State:IL
Mailing Address - Zip Code:60442-6214
Mailing Address - Country:US
Mailing Address - Phone:708-299-0797
Mailing Address - Fax:
Practice Address - Street 1:100 BATSON CT STE 206
Practice Address - Street 2:
Practice Address - City:NEW LENOX
Practice Address - State:IL
Practice Address - Zip Code:60451-1565
Practice Address - Country:US
Practice Address - Phone:815-409-5940
Practice Address - Fax:815-206-8012
Is Sole Proprietor?:No
Enumeration Date:2018-07-09
Last Update Date:2018-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178013967101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health