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General NPI Number Information
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NPI Number | 1154014835
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Entity Type | Individual
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Provider Name | GRADY MICHAEL COOPER
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Gender | Male
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Dates
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Enumeration Date | 05/30/2023
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Last Update Date | 12/08/2025
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Provider Practice Location Address
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Address Line | 810 CLAIRTON BLVD SUITE 500/600
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City | PITTSBURGH
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State | PA
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Zip | 15236-5505
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Country | US
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Telephone | 412-650-1100
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Fax | 412-650-1101
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Provider Business Mailing Address
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Address Line | 810 CLAIRTON BLVD STE 500600
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City | PITTSBURGH
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State | PA
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Zip | 15236-5505
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Country | US
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Telephone | 412-650-1100
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Fax | 412-650-1101
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | CW026617
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License Number State | PA
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