Provider Demographics
NPI:1306872924
Name:COOPER PSYCHOLOGICAL ASSOCIATES, INC.
Entity type:Organization
Organization Name:COOPER PSYCHOLOGICAL ASSOCIATES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JANICE
Authorized Official - Middle Name:MARION
Authorized Official - Last Name:COOPER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-821-9422
Mailing Address - Street 1:4949 LIBERTY LANE
Mailing Address - Street 2:SUITE 5
Mailing Address - City:WESCOSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18106-9017
Mailing Address - Country:US
Mailing Address - Phone:610-821-9422
Mailing Address - Fax:610-820-6308
Practice Address - Street 1:4949 LIBERTY LN
Practice Address - Street 2:SUITE 5
Practice Address - City:WESCOSVILLE
Practice Address - State:PA
Practice Address - Zip Code:18106-9014
Practice Address - Country:US
Practice Address - Phone:610-821-9422
Practice Address - Fax:610-820-6308
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-24
Last Update Date:2016-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS 001285-L103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA02308900OtherCAPITAL BLUE CROSS
PA338509OtherHIGHMAR BLUE SHIELD
PA257539000OtherMAGELLAN
PA0059905000OtherINDEPENDENCE BLUE CROSS
PA293720OtherMANAGED HEALTH NETWORK
PA1663388OtherAMERIHEALTH
PA7973084OtherAETNA
PAC38509OtherEPHN
PA338509OtherHIGHMAR BLUE SHIELD