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General NPI Number Information
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NPI Number | 1033908710
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Entity Type | Individual
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Provider Name | KELLY LYNN COOPER LMHC
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Gender | Female
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Dates
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Enumeration Date | 05/01/2025
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Last Update Date | 05/01/2025
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Provider Practice Location Address
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Address Line | 70 E MAIN ST STE F
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City | GREENWOOD
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State | IN
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Zip | 46143-4203
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Country | US
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Telephone | 317-360-5315
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Fax |
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Provider Business Mailing Address
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Address Line | 713 E PLEASANT RUN PARKWAY SOUTH DR
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City | INDIANAPOLIS
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State | IN
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Zip | 46203-3914
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 39003513A
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License Number State | IN
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