Provider Demographics
NPI:1386803781
Name:COOPER, VALERIE C (MED, MA, LPC, CIT)
Entity type:Individual
Prefix:
First Name:VALERIE
Middle Name:C
Last Name:COOPER
Suffix:
Gender:F
Credentials:MED, MA, LPC, CIT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 731
Mailing Address - Street 2:
Mailing Address - City:HOUMA
Mailing Address - State:LA
Mailing Address - Zip Code:70361-0731
Mailing Address - Country:US
Mailing Address - Phone:985-381-1732
Mailing Address - Fax:985-868-7854
Practice Address - Street 1:513 CRESCENT BLVD
Practice Address - Street 2:
Practice Address - City:HOUMA
Practice Address - State:LA
Practice Address - Zip Code:70360-6623
Practice Address - Country:US
Practice Address - Phone:985-381-1732
Practice Address - Fax:985-868-7854
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-02
Last Update Date:2008-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA3376101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional