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NPI Code Detail

MEDICARE: SARAH COOPER LMSW, CCTP

MEDICARE: SARAH COOPER LMSW, CCTP
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
1104100000XSocial WorkerLMSW-16429AZ

General Provider Information

NPI Number : 1154673002
Entity Type Code : Individual
Provider Name (Legal Business Name) : SARAH COOPER LMSW, CCTP
Provider Business Mailing Address
First Line : 2061 W SHANNON ST
Second Line :
City : CHANDLER
State : AZ
Zip : 85224-6992
Country : US
Telephone Number : 317-750-3336
Fax Number :
Provider Business Practice Location Address
First Line : 2102 W BETHANY HOME RD
Second Line :
City : PHOENIX
State : AZ
Zip : 85015-1935
Country : US
Telephone Number : 602-526-8315
Fax Number : 623-205-6516
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/02/2012
Last Update Date : 03/17/2018

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Directions to “ SARAH COOPER LMSW, CCTP” Practice Location

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