Individual
COURTNEY R. COOPER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
10801 JOHNSTON RD, SUITE 230, CHARLOTTE, NC 28226-4558
(704) 999-4619
Mailing address
10801 JOHNSTON RD, SUITE 230, CHARLOTTE, NC 28226-4558
(704) 999-4619
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C004492
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6003587
—
NC
Enumeration date
07/14/2006
Last updated
02/11/2010
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