Individual provider Active NPI

Bethany Lanae' Cooper, PSYD

  • Clinical Child & Adolescent Psychologist
  • Dayton, OH
National Provider Identifier
1033752894
Registry record updated Apr 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X
License
P.08782 Issued in OH
Practice address
9 N Edwin C Moses Blvd
Dayton, OH 45402-8470
Phone
(937) 775-4300
NPI assigned
Oct 24, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Child & Adolescent Psychologist 103TC2200X P.08782 OH Primary
Intellectual & Developmental Disabilities Psychologist 103TM1800X P.08782 OH

Addresses

Primary practice location

9 N Edwin C Moses Blvd
Dayton, OH 45402-8470

Mailing address

PO Box 933421
Cleveland, OH 44193-0039
Phone (937) 641-5072

Other practice location 1

1010 Valley St
Dayton, OH 45404-2070
Phone (937) 641-3401

Other practice location 2

5501 Far Hills Ave Ste 200
Dayton, OH 45429-2203
Phone (937) 436-2866

Other practice location 3

1425 N Fairfield Rd Ste 130
Beavercreek, OH 45432-2674
Phone (937) 320-1950

Other practice location 4

1640 N Limestone St
Springfield, OH 45503-2652
Phone (937) 328-2320

Other practice location 5

204 Patrick Ave
Urbana, OH 43078-2302
Phone (937) 484-6157

Other practice location 6

9000 N Main St Ste 332
Englewood, OH 45415-1185
Phone (937) 832-7337

Other practice location 7

3333 W Tech Rd Ste 220
Miamisburg, OH 45342-0956
Phone (937) 748-6116

Other practice location 8

1 Childrens Plz
Dayton, OH 45404-1815
Phone (937) 641-3401

Other identifiers 1

IdentifierTypeStateIssuer
0138490MedicaidOH

Other names 1

  • Ms. Bethany Lanae' Carrier Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250730001570 OH Practitioner - Clinical Psychologist 7911414222 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Dayton Children'S Hospital Clinical Child & Adolescent CurrentSince Sep 3, 2025 Accepting new patients
Dayton Children'S Hospital CurrentSince Sep 3, 2025 Accepting new patients

Locations

1425 N Fairfield Rd
Ste 130
Beavercreek, OH 45432
Phone (937) 320-1950

5501 Far Hills Ave
Ste 200
Dayton, OH 45429
Phone (937) 436-2866

1 Childrens Plz
Dayton, OH 45404
Phone (937) 641-3600

1010 Valley St
Dayton, OH 45404
Phone (937) 641-3023

9000 N Main St
Ste 332
Englewood, OH 45415
Phone (937) 832-7337

3333 W Tech Rd
Ste 220
Miamisburg, OH 45342
Phone (937) 748-6116

1640 N Limestone St
Springfield, OH 45503
Phone (937) 328-2320

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1571875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775088000000",
    "number": "1033752894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 933421",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441930039",
            "telephone_number": "937-641-5072",
            "fax_number": "937-641-6129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 N EDWIN C MOSES BLVD",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454028470",
            "telephone_number": "937-775-4300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1010 Valley St",
            "address_purpose": "LOCATION",
            "city": "Dayton",
            "state": "OH",
            "postal_code": "454042070",
            "country_code": "US",
            "telephone_number": "937-641-3401",
            "fax_number": "937-641-3046",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5501 Far Hills Ave Ste 200",
            "address_purpose": "LOCATION",
            "city": "Dayton",
            "state": "OH",
            "postal_code": "454292203",
            "country_code": "US",
            "telephone_number": "937-436-2866",
            "fax_number": "937-436-1468",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1425 N Fairfield Rd Ste 130",
            "address_purpose": "LOCATION",
            "city": "Beavercreek",
            "state": "OH",
            "postal_code": "454322674",
            "country_code": "US",
            "telephone_number": "937-320-1950",
            "fax_number": "937-320-9332",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1640 N Limestone St",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "OH",
            "postal_code": "455032652",
            "country_code": "US",
            "telephone_number": "937-328-2320",
            "fax_number": "937-328-2349",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "204 Patrick Ave",
            "address_purpose": "LOCATION",
            "city": "Urbana",
            "state": "OH",
            "postal_code": "430782302",
            "country_code": "US",
            "telephone_number": "937-484-6157",
            "fax_number": "937-484-6181",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9000 N Main St Ste 332",
            "address_purpose": "LOCATION",
            "city": "Englewood",
            "state": "OH",
            "postal_code": "454151185",
            "country_code": "US",
            "telephone_number": "937-832-7337",
            "fax_number": "937-832-4817",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3333 W Tech Rd Ste 220",
            "address_purpose": "LOCATION",
            "city": "Miamisburg",
            "state": "OH",
            "postal_code": "453420956",
            "country_code": "US",
            "telephone_number": "937-748-6116",
            "fax_number": "937-291-6956",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Childrens Plz",
            "address_purpose": "LOCATION",
            "city": "Dayton",
            "state": "OH",
            "postal_code": "454041815",
            "country_code": "US",
            "telephone_number": "937-641-3401",
            "fax_number": "937-641-3046",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COOPER",
        "first_name": "BETHANY",
        "middle_name": "LANAE'",
        "name_prefix": "Mrs.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-24",
        "last_updated": "2026-04-02",
        "certification_date": "2026-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "OH",
            "license": "P.08782",
            "primary": true
        },
        {
            "code": "103TM1800X",
            "taxonomy_group": "",
            "desc": "Psychologist, Intellectual & Developmental Disabilities",
            "state": "OH",
            "license": "P.08782",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0138490",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BETHANY",
            "last_name": "CARRIER",
            "middle_name": "LANAE'",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Dayton, OH

Sources for this page

Verify at the official NPI Registry.