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NPI Code Detail

MEDICARE: SARAH ELIZABETH COOPER LCSW

MEDICARE: SARAH ELIZABETH 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 Worker005948CT

General Provider Information

NPI Number : 1437230422
Entity Type Code : Individual
Provider Name (Legal Business Name) : SARAH ELIZABETH COOPER LCSW
Provider Business Mailing Address
First Line : 75 ASMARA WAY
Second Line :
City : EASTON
State : CT
Zip : 06612-2101
Country : US
Telephone Number : 203-502-1073
Fax Number :
Provider Business Practice Location Address
First Line : 184 LIBERTY ST
Second Line :
City : NEW HAVEN
State : CT
Zip : 06519-1625
Country : US
Telephone Number : 203-688-9930
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/18/2006
Last Update Date : 11/09/2010

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Directions to “ SARAH ELIZABETH COOPER LCSW” Practice Location

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