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Individual

MR. DANIEL A. COOPER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LMHC

Contact information

Practice address
102 W. JAY ST, ITHACA, NY 14850-3232
(774) 901-7850
Mailing address
PO BOX 854, ITHACA, NY 14851-0854

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
8636
MA
101YM0800X
Mental Health Counselor
Primary
9328
NY
101YP2500X
Professional Counselor
9328
NY

Other

Enumeration date
06/22/2011
Last updated
11/10/2020
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