Healthcare Provider Details

I. General information

NPI: 1982194189
Provider Name (Legal Business Name): ARIELLE M. COOPER LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/14/2018
Last Update Date: 05/14/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1437 S BELCHER RD
CLEARWATER FL
33764-2829
US

IV. Provider business mailing address

1437 S BELCHER RD
CLEARWATER FL
33764-2829
US

V. Phone/Fax

Practice location:
  • Phone: 727-270-3321
  • Fax: 727-538-7272
Mailing address:
  • Phone: 727-524-4464
  • Fax: 727-538-7272

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW15355
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: