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General NPI Number Information
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NPI Number | 1275103640
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Entity Type | Individual
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Provider Name | CORINNA COOPER LPC
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Gender | Female
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Dates
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Enumeration Date | 06/29/2021
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Last Update Date | 06/23/2025
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Provider Practice Location Address
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Address Line | 512 HIGH ST
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City | MILFORD
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State | OH
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Zip | 45150-1202
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Country | US
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Telephone | 513-947-7000
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Fax |
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Provider Business Mailing Address
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Address Line | 512 HIGH ST
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City | MILFORD
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State | OH
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Zip | 45150-1202
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Country | US
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Telephone | 513-947-7000
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | C2507242
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License Number State | OH
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Legacy Identifiers
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Identifier #1
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Identifier Code | 111381800
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Identifier Type | MEDICAID
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Identifier State | FL
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Identifier Issuer | Florida Medicaid Provider ID
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Proprietary Identifiers Ever Reported
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Identifier #1
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Identifier Code | 111381800
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Identifier Type | MEDICAID
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Identifier State | FL
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Identifier Issuer | Florida Medicaid Provider ID
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