Provider Demographics
NPI:1134354855
Name:COOPER, FRANK GEORGE (MS, LPC)
Entity type:Individual
Prefix:MR
First Name:FRANK
Middle Name:GEORGE
Last Name:COOPER
Suffix:
Gender:M
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 609
Mailing Address - Street 2:
Mailing Address - City:WELCHES
Mailing Address - State:OR
Mailing Address - Zip Code:97067-0609
Mailing Address - Country:US
Mailing Address - Phone:971-678-9542
Mailing Address - Fax:503-622-0547
Practice Address - Street 1:24525 E WELCHES RD
Practice Address - Street 2:
Practice Address - City:WELCHES
Practice Address - State:OR
Practice Address - Zip Code:97067-0347
Practice Address - Country:US
Practice Address - Phone:971-678-9542
Practice Address - Fax:503-622-0547
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-26
Last Update Date:2015-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC0663101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional