Provider Demographics
NPI:1982846945
Name:COOPER, MEREDITH G (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:MEREDITH
Middle Name:G
Last Name:COOPER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:191 BETHPAGE SWEET HOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:OLD BETHPAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11804-1342
Mailing Address - Country:US
Mailing Address - Phone:516-870-1665
Mailing Address - Fax:516-870-1656
Practice Address - Street 1:405 LOCUST AVE
Practice Address - Street 2:
Practice Address - City:OAKDALE
Practice Address - State:NY
Practice Address - Zip Code:11769-1651
Practice Address - Country:US
Practice Address - Phone:631-567-1626
Practice Address - Fax:631-567-1648
Is Sole Proprietor?:No
Enumeration Date:2009-04-06
Last Update Date:2016-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0772881041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical