Provider Demographics
NPI:1023708302
Name:COOPER, KEARA KATHERINE (LCSW)
Entity type:Individual
Prefix:
First Name:KEARA
Middle Name:KATHERINE
Last Name:COOPER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:445 ORIANA RD STE 2
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23608-3742
Mailing Address - Country:US
Mailing Address - Phone:757-603-1153
Mailing Address - Fax:276-300-1350
Practice Address - Street 1:445 ORIANA RD STE 2
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23608-3742
Practice Address - Country:US
Practice Address - Phone:646-604-1153
Practice Address - Fax:276-300-1350
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-10
Last Update Date:2025-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040152541041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical