Healthcare Provider Details

I. General information

NPI: 1174489439
Provider Name (Legal Business Name): COOPER & COOPER MENTAL HEALTH GROUP PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/30/2025
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5111 ROGERS AVE STE 511
FORT SMITH AR
72903-2047
US

IV. Provider business mailing address

5111 ROGERS AVE STE 511
FORT SMITH AR
72903-2047
US

V. Phone/Fax

Practice location:
  • Phone: 479-551-8420
  • Fax: 501-426-8270
Mailing address:
  • Phone: 479-551-8420
  • Fax: 501-426-8270

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateNULL

VIII. Authorized Official

Name: COLTON COOPER
Title or Position: OWNER
Credential: BA
Phone: 479-222-4153