Healthcare Provider Details

I. General information

NPI: 1174172902
Provider Name (Legal Business Name): SUZANNE COOPER LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/04/2019
Last Update Date: 09/04/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7921 SOUTHPARK PLZ STE 204
LITTLETON CO
80120-4506
US

IV. Provider business mailing address

7522 S COVE CIR
CENTENNIAL CO
80122-3333
US

V. Phone/Fax

Practice location:
  • Phone: 720-489-8555
  • Fax:
Mailing address:
  • Phone: 303-241-6059
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPCC.0016887
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: