=====================================================
General NPI Number Information
=====================================================
NPI Number | 1184551566
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CAYSEA COOPER
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/07/2026
-----------------------------------------------------
Last Update Date | 05/07/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1990 LOUISVILLE RD STE 110
-----------------------------------------------------
City | BOWLING GREEN
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 42101-1202
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 270-782-2100
-----------------------------------------------------
Fax | 270-782-2107
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1238 CHAUMOUNT RD
-----------------------------------------------------
City | PARK CITY
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 42160-9391
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 270-308-6794
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YA0400X
-----------------------------------------------------
Taxonomy Name | Addiction (Substance Use Disorder) Counselor
-----------------------------------------------------
License Number | 251525
-----------------------------------------------------
License Number State | KY
-----------------------------------------------------