Provider Demographics
NPI:1811155971
Name:COOPER, ANGELA CHRISTINE (LPC)
Entity type:Individual
Prefix:MR
First Name:ANGELA
Middle Name:CHRISTINE
Last Name:COOPER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MISS
Other - First Name:ANGELA
Other - Middle Name:CHRISTINE
Other - Last Name:WHATLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:N/A
Mailing Address - Street 1:903 NORTH ST
Mailing Address - Street 2:
Mailing Address - City:NACOGDOCHES
Mailing Address - State:TX
Mailing Address - Zip Code:75961-4479
Mailing Address - Country:US
Mailing Address - Phone:936-564-4064
Mailing Address - Fax:936-564-1570
Practice Address - Street 1:903 NORTH ST
Practice Address - Street 2:
Practice Address - City:NACOGDOCHES
Practice Address - State:TX
Practice Address - Zip Code:75961-4479
Practice Address - Country:US
Practice Address - Phone:936-564-4064
Practice Address - Fax:936-564-1570
Is Sole Proprietor?:No
Enumeration Date:2008-05-27
Last Update Date:2008-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX60330101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional