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NPI Code Detail

MEDICARE: BRITAINEY COOPER MA, ED.S, NCSP

MEDICARE:   BRITAINEY  COOPER  MA, ED.S, NCSP
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
1103TS0200XSchool Psychologist46326WV
2103TC2200XClinical Child & Adolescent Psychologist6627NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
16627OTHERNCNC PSYCH BOARD LICENSE

General Provider Information

NPI Number : 1235657701
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRITAINEY COOPER MA, ED.S, NCSP
Provider Business Mailing Address
First Line : 440 MOTTS CREEK RD
Second Line :
City : WILMINGTON
State : NC
Zip : 28412-7854
Country : US
Telephone Number : 304-377-6252
Fax Number :
Provider Business Practice Location Address
First Line : 2601 IRON GATE DR STE 101
Second Line :
City : WILMINGTON
State : NC
Zip : 28412-6624
Country : US
Telephone Number : 910-202-9113
Fax Number : 910-202-9289
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/06/2017
Last Update Date : 12/10/2024

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Directions to “ BRITAINEY COOPER MA, ED.S, NCSP” Practice Location

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