Provider Demographics
NPI:1306234158
Name:COOPER, CURTIS TIMOTHY I (MACC, NCC)
Entity type:Individual
Prefix:MR
First Name:CURTIS
Middle Name:TIMOTHY
Last Name:COOPER
Suffix:I
Gender:M
Credentials:MACC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1243 LIBERTY ST STE 205
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:PA
Mailing Address - Zip Code:16323-1331
Mailing Address - Country:US
Mailing Address - Phone:814-657-2067
Mailing Address - Fax:
Practice Address - Street 1:1243 LIBERTY ST STE 205
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:PA
Practice Address - Zip Code:16323-1331
Practice Address - Country:US
Practice Address - Phone:814-657-2067
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-02
Last Update Date:2015-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional