Provider Demographics
NPI:1396148052
Name:COOPER, LINDSAY SIDNEY (LCPC)
Entity type:Individual
Prefix:
First Name:LINDSAY
Middle Name:SIDNEY
Last Name:COOPER
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 CENTRAL AVE STE 308
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59401-3128
Mailing Address - Country:US
Mailing Address - Phone:406-836-7494
Mailing Address - Fax:064-403-0332
Practice Address - Street 1:410 CENTRAL AVE STE 308
Practice Address - Street 2:
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59401-3128
Practice Address - Country:US
Practice Address - Phone:406-836-7494
Practice Address - Fax:064-403-0332
Is Sole Proprietor?:No
Enumeration Date:2014-10-08
Last Update Date:2022-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT8587101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health