Provider Demographics
NPI:1669779526
Name:COOPER, YVONNE LEVETTE (LCSW)
Entity type:Individual
Prefix:MS
First Name:YVONNE
Middle Name:LEVETTE
Last Name:COOPER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:810 W THOMAS ST
Mailing Address - Street 2:
Mailing Address - City:ROCKY MOUNT
Mailing Address - State:NC
Mailing Address - Zip Code:27804-5227
Mailing Address - Country:US
Mailing Address - Phone:919-865-8780
Mailing Address - Fax:919-865-8781
Practice Address - Street 1:60 NC HIGHWAY 125
Practice Address - Street 2:
Practice Address - City:ROANOKE RAPIDS
Practice Address - State:NC
Practice Address - Zip Code:27870-6304
Practice Address - Country:US
Practice Address - Phone:252-537-6619
Practice Address - Fax:252-308-0830
Is Sole Proprietor?:No
Enumeration Date:2011-02-11
Last Update Date:2018-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0080571041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCC008057OtherLCSW