Cooper, Addison

Cooper, Addison is an individual health care provider with primary practice located at 1881 Business Center Dr Ste 10A , San Bernardino CA 92408-3438. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Cooper, Addison can be contacted via phone (909) 890-2381.

Contact Information

Primary practice address
1881 Business Center Dr Ste 10A San Bernardino CA 92408-3438
Phone: (909) 890-2381
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 27804 California
Behavioral Health & Social Service Providers / Clinical 1041C0700X 2012015566 Missouri

Profile Details

NPI number 1578809463
LBN Legal business name Cooper, Addison
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 20th, 2012
Last updated Jan 27th, 2017 - about 9 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1578809463 NPPES
Missouri Other 2012015566 LICENSE
Missouri Other 27804 LICENSE

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