Organization
COOPER COUNSELING SERVICES PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISTY COOPER LPC-S (OWNER)
(918) 605-9202
Entity
Organization
Contact information
Practice address
10310 N 138TH EAST AVE STE 201, OWASSO, OK 74055-4641
(405) 254-6081
Mailing address
10310 N 138TH EAST AVE STE 201, OWASSO, OK 74055-4641
(405) 254-6081
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200474420
—
OK
Enumeration date
06/03/2019
Last updated
06/11/2019
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