Individual
JALEN COOPER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW, SAC-IT
Contact information
Practice address
1610 MILLER PARK WAY, MILWAUKEE, WI 53214-3604
(414) 310-1248
(414) 672-6026
Mailing address
4001 W CAPITOL DR, MILWAUKEE, WI 53216-2530
(414) 455-3879
(866) 719-3024
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
1965-130
WI
1041C0700X
Clinical Social Worker
Primary
—
WI
Other
Enumeration date
03/25/2022
Last updated
06/07/2024
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