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NPI Code Detail

MEDICARE: MS. MARIAN A. COOPER LCSW

MEDICARE: MS. MARIAN A. 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 Worker084473NY
21041C0700XClinical Social Worker104193TX

General Provider Information

NPI Number : 1659643443
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. MARIAN A. COOPER LCSW
Provider Business Mailing Address
First Line : 13810 CHAMPION FOREST DR STE 150
Second Line :
City : HOUSTON
State : TX
Zip : 77069-1883
Country : US
Telephone Number : 646-470-1820
Fax Number :
Provider Business Practice Location Address
First Line : 13810 CHAMPION FOREST DR STE 150
Second Line :
City : HOUSTON
State : TX
Zip : 77069-1883
Country : US
Telephone Number : 646-470-1820
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/08/2012
Last Update Date : 11/27/2023

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77069-1883
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Practice Location Address:
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1356707913 — KRISTA LEWIS PMHNP
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