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NPI Code Detail

MEDICARE: ELIZABETH MARY COOPER LCSW

MEDICARE: ELIZABETH MARY COOPER LCSW
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
11041C0700XClinical Social Worker133681901SC
21041C0700XClinical Social WorkerC019325NC

General Provider Information

NPI Number : 1255079380
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELIZABETH MARY COOPER LCSW
Provider Business Mailing Address
First Line : PO BOX 40908
Second Line :
City : FAYETTEVILLE
State : NC
Zip : 28309-0908
Country : US
Telephone Number : 910-615-3333
Fax Number :
Provider Business Practice Location Address
First Line : 711 EXECUTIVE PL
Second Line :
City : FAYETTEVILLE
State : NC
Zip : 28305-5193
Country : US
Telephone Number : 910-615-3333
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/27/2022
Last Update Date : 05/06/2026

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Directions to “ ELIZABETH MARY COOPER LCSW” Practice Location

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