Provider Demographics
NPI:1699737221
Name:COOPER, HEATHER A (MED, LPCC)
Entity type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:A
Last Name:COOPER
Suffix:
Gender:F
Credentials:MED, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8790 E MARKET ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:WARREN
Mailing Address - State:OH
Mailing Address - Zip Code:44484-2360
Mailing Address - Country:US
Mailing Address - Phone:330-841-1160
Mailing Address - Fax:330-841-1176
Practice Address - Street 1:8790 E MARKET ST
Practice Address - Street 2:SUITE 300
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44484-2360
Practice Address - Country:US
Practice Address - Phone:330-841-1160
Practice Address - Fax:330-841-1176
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE2938101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health