Individual
ANTHONY COOLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CDCA
Contact information
Practice address
702 4TH ST E, SOUTH POINT, OH 45680-7111
(740) 534-2100
Mailing address
702 4TH ST E, SOUTH POINT, OH 45680-7111
(405) 342-1007
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CDCA.188180
OH
101YM0800X
Mental Health Counselor
—
—
171M00000X
Case Manager/Care Coordinator
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0009220
—
OH
Enumeration date
02/07/2023
Last updated
08/05/2024
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