Provider Demographics
NPI:1982800223
Name:COOPER, ANNE MARIE (MA, LPC)
Entity Type:Individual
Prefix:MRS
First Name:ANNE
Middle Name:MARIE
Last Name:COOPER
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 W PATERSON ST # SR
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49007-1710
Mailing Address - Country:US
Mailing Address - Phone:269-343-6185
Mailing Address - Fax:269-492-1748
Practice Address - Street 1:1000 W PATERSON ST # SR
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49007-1710
Practice Address - Country:US
Practice Address - Phone:269-343-6185
Practice Address - Fax:269-492-1748
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-24
Last Update Date:2013-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401009965101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional