Individual
COLLEEN COOPER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LCPC
Contact information
Practice address
111 E MAIN ST, ST CHARLES, IL 60174-1948
(630) 587-3777
Mailing address
111 E MAIN ST, ST CHARLES, IL 60174-1948
(630) 587-3777
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
178.0145
IL
101YM0800X
Mental Health Counselor
Primary
180.012509
IL
101YM0800X
Mental Health Counselor
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Other
Enumeration date
04/01/2016
Last updated
11/13/2019
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