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NPI Code Detail

MEDICARE: JAMES PHILIP COOPER-NURSE PHD, LMHC

MEDICARE: JAMES PHILIP COOPER-NURSE PHD, LMHC
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
1101Y00000XCounselorLH60034520WA
2101YM0800XMental Health CounselorLH60034520WA
3101YP2500XProfessional CounselorLH60034520WA
4101YM0800XMental Health CounselorLMHC-025GU

General Provider Information

NPI Number : 1447405212
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMES PHILIP COOPER-NURSE PHD, LMHC
Provider Business Mailing Address
First Line : 790 GOV CARLOS G CAMACHO RD
Second Line :
City : TAMUNING
State : GU
Zip : 96913-3129
Country : US
Telephone Number : 671-647-1902
Fax Number :
Provider Business Practice Location Address
First Line : 790 GOV CARLOS G CAMACHO RD
Second Line :
City : TAMUNING
State : GU
Zip : 96913-3129
Country : US
Telephone Number : 671-647-1902
Fax Number : 671-647-0250
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/20/2008
Last Update Date : 11/19/2024

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