| Cooper Counseling, Llc | |
|
251 Woodford St Portland ME 04103-5617 | |
| (207) 253-9435 | |
| (888) 765-8406 |
| Full Name | Cooper Counseling, Llc |
|---|---|
| Speciality | Psychologist |
| Location | 251 Woodford St, Portland, Maine |
| Authorized Official Name and Position | Carla Kingston (ADMINISTRATOR) |
| Authorized Official Contact | 2074150055 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cooper Counseling, Llc 75 Oceanside Dr Saco ME 04072-1765 Ph: (207) 253-9435 | Cooper Counseling, Llc 251 Woodford St Portland ME 04103-5617 Ph: (207) 253-9435 |
| NPI Number | 1366795338 |
|---|---|
| Provider Enumeration Date | 10/16/2012 |
| Last Update Date | 10/16/2012 |
| Medicare PECOS PAC ID | 4082866637 |
|---|---|
| Medicare Enrollment ID | O20121206000484 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366795338 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Thomas Cooper |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1154674109 PECOS PAC ID: 7517119068 Enrollment ID: I20121207000075 |
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