Provider Demographics
NPI:1285441543
Name:COOMER, LINDSEY (LPC-A)
Entity type:Individual
Prefix:
First Name:LINDSEY
Middle Name:
Last Name:COOMER
Suffix:
Gender:F
Credentials:LPC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:721 RANCH HOUSE RD
Mailing Address - Street 2:
Mailing Address - City:WILLOW PARK
Mailing Address - State:TX
Mailing Address - Zip Code:76087-7613
Mailing Address - Country:US
Mailing Address - Phone:817-995-2553
Mailing Address - Fax:
Practice Address - Street 1:721 RANCH HOUSE RD
Practice Address - Street 2:
Practice Address - City:WILLOW PARK
Practice Address - State:TX
Practice Address - Zip Code:76087-7613
Practice Address - Country:US
Practice Address - Phone:817-995-2553
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-11
Last Update Date:2024-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX94525101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional