Provider Demographics
NPI:1619984044
Name:COOPER, DAVID JOSEPH (MED LPCC)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:JOSEPH
Last Name:COOPER
Suffix:
Gender:M
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 1:12608 STATE ROAD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44133-3208
Mailing Address - Country:US
Mailing Address - Phone:440-230-1960
Mailing Address - Fax:440-230-1965
Practice Address - Street 1:12608 STATE ROAD
Practice Address - Street 2:SUITE 1
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44133-3208
Practice Address - Country:US
Practice Address - Phone:440-230-1960
Practice Address - Fax:440-230-1965
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health