Individual
CAROLYN M COOPER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
3401 PEGER RD STE C, FAIRBANKS, AK 99709-5488
(907) 374-7076
(907) 374-7078
Mailing address
3401 PEGER RD STE C, FAIRBANKS, AK 99709-5488
(907) 374-7076
(907) 374-7078
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
240969
AK
101Y00000X
Counselor
—
—
106S00000X
Behavior Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
MH0157
—
AK
Enumeration date
08/17/2010
Last updated
05/31/2026
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