Healthcare Provider Details

I. General information

NPI: 1144132655
Provider Name (Legal Business Name): EMILY COOPER LPC, NCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10958 OAK LN APT 6316
VAN BUREN TOWNSHIP MI
48111-4377
US

IV. Provider business mailing address

10958 OAK LN APT 6316
VAN BUREN TOWNSHIP MI
48111-4377
US

V. Phone/Fax

Practice location:
  • Phone: 734-290-3542
  • Fax:
Mailing address:
  • Phone: 734-290-3542
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number6401226577
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: