Provider Demographics
NPI:1134515224
Name:COOLEY, JOHN LUNSFORD (PHD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:LUNSFORD
Last Name:COOLEY
Suffix:
Gender:M
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:BOX 42051
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79409-2051
Mailing Address - Country:US
Mailing Address - Phone:806-834-5194
Mailing Address - Fax:
Practice Address - Street 1:1901 UNIVERSITY AVE RM 103
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79410-1544
Practice Address - Country:US
Practice Address - Phone:806-834-5194
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-15
Last Update Date:2024-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX39946103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent