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NPI Code Detail

MEDICARE: MS. TEAWANNA COOPER LCSWR QMHP-A/C M.ED.

MEDICARE: MS. TEAWANNA COOPER LCSWR QMHP-A/C M.ED.
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
1374U00000XHome Health Aide
2101YM0800XMental Health Counselor0732009862VA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1853474580OTHERVAIRS

General Provider Information

NPI Number : 1427340876
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. TEAWANNA COOPER LCSWR QMHP-A/C M.ED.
Provider Business Mailing Address
First Line : 900 COMMONWEALTH PL STE 200
Second Line : 392
City : VIRGINIA BEACH
State : VA
Zip : 23464-4530
Country : US
Telephone Number : 757-788-3033
Fax Number :
Provider Business Practice Location Address
First Line : 900 COMMONWEALTH PL STE 200
Second Line :
City : VIRGINIA BEACH
State : VA
Zip : 23464-4530
Country : US
Telephone Number : 757-788-3033
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/04/2011
Last Update Date : 02/09/2024

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Directions to “ MS. TEAWANNA COOPER LCSWR QMHP-A/C M.ED.” Practice Location

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