Cooner, Courtney
Cooner, Courtney is an sole proprietor health care provider with primary practice located at 2115 S Broadway Ave , Tyler TX 75701-4214. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Cooner, Courtney can be contacted via phone (903) 907-7002.Contact Information
Primary practice address
2115 S Broadway Ave
Tyler TX 75701-4214
Phone: (903) 907-7002
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 31025 | Texas |
Profile Details
| NPI number | 1174711220 |
|---|---|
| LBN Legal business name | Cooner, Courtney |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 12th, 2007 |
| Last updated | Jun 28th, 2023 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1174711220 | NPPES |
| Texas | MEDICAID | 165570601 |
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