Provider Demographics
NPI:1952492803
Name:KOOP, FAYE A (PHD)
Entity Type:Individual
Prefix:DR
First Name:FAYE
Middle Name:A
Last Name:KOOP
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 N SPENCER RD
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:KS
Mailing Address - Zip Code:67114-9481
Mailing Address - Country:US
Mailing Address - Phone:316-284-9856
Mailing Address - Fax:316-284-9856
Practice Address - Street 1:1800 N SPENCER RD
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:KS
Practice Address - Zip Code:67114-9481
Practice Address - Country:US
Practice Address - Phone:316-284-9856
Practice Address - Fax:316-284-9856
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS213106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
0000382109OtherBLUE CROSS BLUE SHIELD
2127249OtherFIRST HEALTH
207744OtherCOMPSYCH
KS5530OtherPREFERRED HEALTH SYSTEMS
KS203446OtherHEALTH PARTNERS OF KANSAS