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NPI Code Detail

MEDICARE: NIESHA COOPER LPCC

MEDICARE: NIESHA COOPER LPCC
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
1101YP2500XProfessional CounselorC.2204368OH
2101Y00000XCounselorE.2606120OH

General Provider Information

NPI Number : 1881212603
Entity Type Code : Individual
Provider Name (Legal Business Name) : NIESHA COOPER LPCC
Provider Business Mailing Address
First Line : PO BOX 396
Second Line :
City : SPRINGBORO
State : OH
Zip : 45066-0396
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 220 S BREIEL BLVD
Second Line :
City : MIDDLETOWN
State : OH
Zip : 45044-5106
Country : US
Telephone Number : 513-849-8670
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/08/2020
Last Update Date : 03/19/2026

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