Stacie Lyn Cooper, PSY.D.

Individual provider Active NPI Mental Health Counselor · San Juan Capistrano, CA

NPI 1003044306 · NPPES record last updated Jun 24, 2009

Key facts

NPI
1003044306
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
Practice address
26891 Spring St
San Juan Capistrano, CA 92675-2692
Phone
(949) 361-7892
NPI assigned
Jun 24, 2009
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Yes

Addresses

Primary practice location

26891 Spring St
San Juan Capistrano, CA 92675-2692

Mailing address

26891 Spring St
San Juan Capistrano, CA 92675-2692

Other names

  • Stacie Lyn Cooper Eshelman Other name

Other providers in San Juan Capistrano, CA

All providers in San Juan Capistrano, CA · Mental Health Counselor in California

Sources for this page

Verify at the official NPI Registry.