Individual
JENNIFER COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC, CADCII
Contact information
Practice address
3500 NE MLK BLVD STE 200, PORTLAND, OR 97212-2093
(503) 237-8205
Mailing address
1604A NE 59TH AVE, PORTLAND, OR 97213-4244
(503) 915-8290
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
10R21
OR
101YM0800X
Mental Health Counselor
Primary
C3479
OR
101YP2500X
Professional Counselor
Primary
C3479
OR
Other
Enumeration date
01/08/2013
Last updated
03/13/2026
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