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Individual

MR. CARL RISPERS COOPER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MRC, CRC, LCMHC, CBH

Contact information

Practice address
1110 PHAR LAP DR, INDIAN TRAIL, NC 28079-5751
(704) 807-3044
Mailing address
1110 PHAR LAP DR, INDIAN TRAIL, NC 28079-5751
(704) 292-0834

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
941
NC
101YM0800X
Mental Health Counselor
Primary
9141
NC
101YP2500X
Professional Counselor
9141
NC
225C00000X
Rehabilitation Counselor
00113409

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00113409
CERTIFIED REHABILITATION COUNSELOR
01
9141
LICENSED PROFESSIONAL MENTAL HEALTH COUNSELOR
NC
Enumeration date
07/03/2013
Last updated
08/09/2024
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