Provider Demographics
NPI:1912931320
Name:COOPERMAN, WARREN LAWRENCE (PHD)
Entity Type:Individual
Prefix:DR
First Name:WARREN
Middle Name:LAWRENCE
Last Name:COOPERMAN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22255 CENTER RIDGE RD
Mailing Address - Street 2:#308
Mailing Address - City:ROCKY RIVER
Mailing Address - State:OH
Mailing Address - Zip Code:44116-3964
Mailing Address - Country:US
Mailing Address - Phone:440-331-4990
Mailing Address - Fax:
Practice Address - Street 1:22255 CENTER RIDGE RD
Practice Address - Street 2:#308
Practice Address - City:ROCKY RIVER
Practice Address - State:OH
Practice Address - Zip Code:44116-3964
Practice Address - Country:US
Practice Address - Phone:440-331-4990
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH359103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist