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1205047289 NPI number — FELISIA HODGES COOPER MS, PCMHT

NPI Number: 1205047289
Health Care Provider/Practitioner: FELISIA HODGES COOPER MS, PCMHT

Information about “1205047289” NPI (FELISIA HODGES COOPER MS, PCMHT) exists in 1205047289 in HTML format HTML  |  1205047289 in plain Text format TXT  |  1205047289 in PDF (Portable Document Format) PDF  |  1205047289 in an XML format XML  formats.

NPI Number : 1205047289 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1205047289",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "COOPER",
    "FirstName": "FELISIA",
    "MiddleName": "HODGES",
    "NamePrefix": "MRS.",
    "NameSuffix": null,
    "Credential": "MS, PCMHT",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "923 HILLSIDE PARK",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "WEST POINT",
    "MailingAddressStateName": "MS",
    "MailingAddressPostalCode": "39773-2045",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "662-840-3008",
    "MailingAddressFaxNumber": "662-840-0337",
    "FirstLinePracticeLocationAddress": "252 S VETERANS BLVD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "TUPELO",
    "PracticeLocationAddressStateName": "MS",
    "PracticeLocationAddressPostalCode": "38804-5022",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "662-840-3008",
    "PracticeLocationAddressFaxNumber": "662-841-0337",
    "EnumerationDate": "05/24/2007",
    "LastUpdateDate": "07/08/2007",
    "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": null,
        "LicenseNumberStateCode": null,
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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