Provider Demographics
NPI:1013346477
Name:COOPER, PETE (MS, LPC)
Entity Type:Individual
Prefix:
First Name:PETE
Middle Name:
Last Name:COOPER
Suffix:
Gender:M
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 N CAUSEWAY BLVD STE B
Mailing Address - Street 2:SUITE B
Mailing Address - City:MANDEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70471-3173
Mailing Address - Country:US
Mailing Address - Phone:985-882-1233
Mailing Address - Fax:985-809-6909
Practice Address - Street 1:2000 N CAUSEWAY BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:MANDEVILLE
Practice Address - State:LA
Practice Address - Zip Code:70471-3154
Practice Address - Country:US
Practice Address - Phone:985-882-1233
Practice Address - Fax:985-089-6909
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-06
Last Update Date:2015-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
5137101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional