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NPI Code Detail

MEDICARE: RACHEL COOPER LCSW

MEDICARE: RACHEL COOPER LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker9685429-3501UT

General Provider Information

NPI Number : 1073820270
Entity Type Code : Individual
Provider Name (Legal Business Name) : RACHEL COOPER LCSW
Provider Business Mailing Address
First Line : 1072 W 1150 S
Second Line :
City : SPRINGVILLE
State : UT
Zip : 84663-6161
Country : US
Telephone Number : 207-240-8891
Fax Number :
Provider Business Practice Location Address
First Line : 3311 N UNIVERSITY AVE STE 200
Second Line :
City : PROVO
State : UT
Zip : 84604-7421
Country : US
Telephone Number : 801-310-4188
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/09/2010
Last Update Date : 03/06/2023

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