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General NPI Number Information
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NPI Number | 1912760059
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Entity Type | Organization
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Legal Business Name | CHERYL LCOOP LMHC
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Dates
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Enumeration Date | 02/01/2024
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Last Update Date | 04/15/2024
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Provider Practice Location Address
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Address Line | 6046 PORTAL WAY STE 104
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City | FERNDALE
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State | WA
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Zip | 98248-7829
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Country | US
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Telephone | 360-820-6397
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 273
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City | FERNDALE
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State | WA
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Zip | 98248-0273
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Country | US
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Telephone | 360-820-6397
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Fax |
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Authorized Official
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Title or Position | BUSINESS OWNER/LMHC
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Name | MS. CHERYL LYNN COOP
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Credential | M.C.
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Telephone | 360-820-6397
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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