Mary Cooper, LCSW
Individual provider Active NPI Mental Health Counselor · Checotah, OK
NPI 1124300769 · NPPES record last updated Dec 18, 2019
Key facts
- NPI
- 1124300769
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- Practice address
- 229 W Gentry Ave
Checotah, OK 74426-2439 - Phone
- (918) 473-1575
- NPI assigned
- Sep 9, 2011
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Choices for Life Foster Care, Inc. | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Yes |
Addresses
Primary practice location
229 W Gentry Ave
Checotah, OK 74426-2439
Mailing address
313 SE 1St St
Checotah, OK 74426-5035
Phone (918) 473-3003
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1007745880 | Medicaid | OK |
Other providers in Checotah, OK
- City of Checotah
- Clayborn Family Clinic, LLC
- Barbara Louann Cobaugh
- Heath Bryan Coleman
- Leah Renee Cook
- Erin Elizabeth Corbin
- Kathy Dan
- Stephanie Lee Davis
- Kenneth Wayne Dewitt
- Casi Dowdy
All providers in Checotah, OK · Mental Health Counselor in Oklahoma
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 18, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.