Provider Demographics
NPI:1295923878
Name:COOPER, ANEITA F (PHD, LPC)
Entity type:Individual
Prefix:
First Name:ANEITA
Middle Name:F
Last Name:COOPER
Suffix:
Gender:F
Credentials:PHD, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4752 HIGHWAY 49 S
Mailing Address - Street 2:
Mailing Address - City:PARAGOULD
Mailing Address - State:AR
Mailing Address - Zip Code:72450-8808
Mailing Address - Country:US
Mailing Address - Phone:870-240-4225
Mailing Address - Fax:855-933-0240
Practice Address - Street 1:908 W COURT ST
Practice Address - Street 2:
Practice Address - City:PARAGOULD
Practice Address - State:AR
Practice Address - Zip Code:72450
Practice Address - Country:US
Practice Address - Phone:702-404-2258
Practice Address - Fax:855-933-0240
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-09
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARP1212115101Y00000X
101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor