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1053809749 NPI number — VICTORIA MARIE COOPER LPCC-S

NPI Number: 1053809749
Health Care Provider/Practitioner: VICTORIA MARIE COOPER LPCC-S

Information about “1053809749” NPI (VICTORIA MARIE COOPER LPCC-S) exists in 1053809749 in HTML format HTML  |  1053809749 in plain Text format TXT  |  1053809749 in PDF (Portable Document Format) PDF  |  1053809749 in an XML format XML  formats.

NPI Number : 1053809749 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1053809749",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "COOPER",
    "FirstName": "VICTORIA",
    "MiddleName": "MARIE",
    "NamePrefix": "MRS.",
    "NameSuffix": null,
    "Credential": "LPCC-S",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "BONI",
    "OtherFirstName": "VICTORIA",
    "OtherMiddleName": "MARIE",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "2680 W MARKET ST",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "FAIRLAWN",
    "MailingAddressStateName": "OH",
    "MailingAddressPostalCode": "44333-4215",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "234-867-5001",
    "MailingAddressFaxNumber": "234-867-5002",
    "FirstLinePracticeLocationAddress": "2680 W MARKET ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "FAIRLAWN",
    "PracticeLocationAddressStateName": "OH",
    "PracticeLocationAddressPostalCode": "44333-4215",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "234-867-5001",
    "PracticeLocationAddressFaxNumber": "234-867-5002",
    "EnumerationDate": "04/27/2018",
    "LastUpdateDate": "04/01/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "101Y00000X",
          "TaxonomyName": "Counselor",
          "LicenseNumber": "C.1700625-TRNE",
          "LicenseNumberStateCode": "OH",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "101YP2500X",
          "TaxonomyName": "Professional Counselor",
          "LicenseNumber": "E.2102087",
          "LicenseNumberStateCode": "OH",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "101YM0800X",
          "TaxonomyName": "Mental Health Counselor",
          "LicenseNumber": "E.2102087",
          "LicenseNumberStateCode": "OH",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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