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General NPI Number Information
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NPI Number | 1528613106
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Entity Type | Organization
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Legal Business Name | COOPER COUNSELING LLC
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Dates
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Enumeration Date | 08/09/2019
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Last Update Date | 11/24/2023
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Provider Practice Location Address
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Address Line | 1145 M ST
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City | GERING
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State | NE
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Zip | 69341-2835
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Country | US
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Telephone | 308-631-5523
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Fax |
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Provider Business Mailing Address
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Address Line | 1145 M ST
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City | GERING
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State | NE
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Zip | 69341-2835
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Country | US
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Telephone | 308-631-5523
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Fax |
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Authorized Official
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Title or Position | SUBSTANCE ABUSE COUNSELOR
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Name | MS. PENNY L COOPER
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Credential | PLADC
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Telephone | 308-631-5523
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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