Provider Demographics
NPI:1891370136
Name:COOPER, VELVA ANN (LCPC)
Entity type:Individual
Prefix:MS
First Name:VELVA
Middle Name:ANN
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 1:825 WATERFORD DR
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21702-4093
Mailing Address - Country:US
Mailing Address - Phone:443-876-5385
Mailing Address - Fax:
Practice Address - Street 1:7001 JOHNNYCAKE RD STE 101
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21244-2419
Practice Address - Country:US
Practice Address - Phone:866-968-6342
Practice Address - Fax:866-615-2876
Is Sole Proprietor?:No
Enumeration Date:2021-03-17
Last Update Date:2021-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD9581101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health