Provider Demographics
NPI:1205047289
Name:COOPER, FELISIA HODGES (MS, PCMHT)
Entity type:Individual
Prefix:MRS
First Name:FELISIA
Middle Name:HODGES
Last Name:COOPER
Suffix:
Gender:F
Credentials:MS, PCMHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:923 HILLSIDE PARK
Mailing Address - Street 2:
Mailing Address - City:WEST POINT
Mailing Address - State:MS
Mailing Address - Zip Code:39773-2045
Mailing Address - Country:US
Mailing Address - Phone:662-840-3008
Mailing Address - Fax:662-840-0337
Practice Address - Street 1:252 S VETERANS BLVD
Practice Address - Street 2:
Practice Address - City:TUPELO
Practice Address - State:MS
Practice Address - Zip Code:38804-5022
Practice Address - Country:US
Practice Address - Phone:662-840-3008
Practice Address - Fax:662-841-0337
Is Sole Proprietor?:No
Enumeration Date:2007-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor