MEDICARE: CHRISTINA COOPER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	37AC00872800	NJ

General Provider Information

NPI Number	:	1225813157
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINA COOPER

Provider Business Mailing Address
First Line	:	343 OLD GEORGES RD STE 201
Second Line	:
City	:	NORTH BRUNSWICK
State	:	NJ
Zip	:	08902-4801
Country	:	US
Telephone Number	:	732-982-2888
Fax Number	:

Provider Business Practice Location Address
First Line	:	343 OLD GEORGES RD STE 201
Second Line	:
City	:	NORTH BRUNSWICK
State	:	NJ
Zip	:	08902-4801
Country	:	US
Telephone Number	:	732-982-2888
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/29/2023
Last Update Date	:	07/02/2025

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Directions to “ CHRISTINA COOPER ” Practice Location

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