Provider Demographics
NPI:1740089390
Name:EATON, COOPER L (MA NCC)
Entity type:Individual
Prefix:
First Name:COOPER
Middle Name:L
Last Name:EATON
Suffix:
Gender:
Credentials:MA NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4317 SUNSET AVE
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37411-3266
Mailing Address - Country:US
Mailing Address - Phone:423-619-0219
Mailing Address - Fax:
Practice Address - Street 1:5726 MARLIN RD STE 315
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37411-5668
Practice Address - Country:US
Practice Address - Phone:423-619-0219
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-07
Last Update Date:2025-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health