1306872924 NPI number — COOPER PSYCHOLOGICAL ASSOCIATES, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1306872924 NPI number — COOPER PSYCHOLOGICAL ASSOCIATES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COOPER PSYCHOLOGICAL ASSOCIATES, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1306872924
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/28/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4949 LIBERTY LANE
Provider Second Line Business Mailing Address:
SUITE 5
Provider Business Mailing Address City Name:
WESCOSVILLE
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
18106-9017
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
610-821-9422
Provider Business Mailing Address Fax Number:
610-820-6308

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4949 LIBERTY LN
Provider Second Line Business Practice Location Address:
SUITE 5
Provider Business Practice Location Address City Name:
WESCOSVILLE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18106-9014
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-821-9422
Provider Business Practice Location Address Fax Number:
610-820-6308
Provider Enumeration Date:
06/24/2006

Additional Information

Authorized Official

Authorized Official Last Name:
COOPER
Authorized Official First Name:
JANICE
Authorized Official Middle Name:
MARION
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
610-821-9422

Provider Taxonomy Codes

  • Taxonomy code: 103T00000X , with the licence number:  PS 001285-L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 02308900 . This is a "CAPITAL BLUE CROSS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 338509 . This is a "HIGHMAR BLUE SHIELD" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 257539000 . This is a "MAGELLAN" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0059905000 . This is a "INDEPENDENCE BLUE CROSS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 293720 . This is a "MANAGED HEALTH NETWORK" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1663388 . This is a "AMERIHEALTH" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 7973084 . This is a "AETNA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: C38509 . This is a "EPHN" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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