Provider Demographics
NPI:1124495510
Name:COOPER DAY, SHELBY (LCSW)
Entity type:Individual
Prefix:MS
First Name:SHELBY
Middle Name:
Last Name:COOPER DAY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 ALDERSGATE RD STE 200
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-6676
Mailing Address - Country:US
Mailing Address - Phone:501-661-0720
Mailing Address - Fax:
Practice Address - Street 1:2239 S CARAWAY RD
Practice Address - Street 2:SUITE M
Practice Address - City:JONESBORO
Practice Address - State:AR
Practice Address - Zip Code:72401-6204
Practice Address - Country:US
Practice Address - Phone:870-910-3757
Practice Address - Fax:870-910-4999
Is Sole Proprietor?:No
Enumeration Date:2015-09-01
Last Update Date:2022-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103K00000X, 171M00000X
AR8882-M104100000X
AR8882C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No171M00000XOther Service ProvidersCase Manager/Care Coordinator