Provider Demographics
NPI:1265918064
Name:COOPER'S COUNSELING, LLC
Entity type:Organization
Organization Name:COOPER'S COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:F
Authorized Official - Last Name:COOPER
Authorized Official - Suffix:
Authorized Official - Credentials:LPC,CAADC
Authorized Official - Phone:814-661-5356
Mailing Address - Street 1:PO BOX 75
Mailing Address - Street 2:
Mailing Address - City:FALLS CREEK
Mailing Address - State:PA
Mailing Address - Zip Code:15840-0075
Mailing Address - Country:US
Mailing Address - Phone:814-661-5356
Mailing Address - Fax:
Practice Address - Street 1:3 S BRADY ST STE 236
Practice Address - Street 2:
Practice Address - City:DU BOIS
Practice Address - State:PA
Practice Address - Zip Code:15801-2159
Practice Address - Country:US
Practice Address - Phone:814-661-5356
Practice Address - Fax:814-690-1994
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-14
Last Update Date:2019-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1000053220001Medicaid