Healthcare Provider Details

I. General information

NPI: 1699689562
Provider Name (Legal Business Name): CRISTEN COOPER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6303 COMMERCE DR STE 175
IRVING TX
75063-2691
US

IV. Provider business mailing address

6303 COMMERCE DR STE 175
IRVING TX
75063-2691
US

V. Phone/Fax

Practice location:
  • Phone: 214-940-9089
  • Fax: 469-437-8635
Mailing address:
  • Phone: 214-940-9089
  • Fax: 469-437-8635

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number97640
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number97640
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: