Cooper, Bethany Lanae'

Cooper, Bethany Lanae' is an individual health care provider with primary practice located at 9 N Edwin C Moses Blvd , Dayton OH 45402-8470. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical Child & Adolescent, Behavioral Health & Social Service Providers / Mental Retardation & Developmental Disabilities. Behavioral Health & Social Service Providers / Clinical Child & Adolescent is her primary health care specialty. Cooper, Bethany Lanae' can be contacted via phone (937) 775-4300.

Contact Information

Primary practice address
9 N Edwin C Moses Blvd Dayton OH 45402-8470
Phone: (937) 775-4300
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical Child & Adolescent 103TC2200X P.08782 Ohio
Behavioral Health & Social Service Providers / Mental Retardation & Developmental Disabilities 103TM1800X P.08782 Ohio

Profile Details

NPI number 1033752894
LBN Legal business name Cooper, Bethany Lanae'
Credentials PSYD
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 24th, 2019
Last updated Apr 2nd, 2026 - about 7 months 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 1033752894 NPPES
Ohio MEDICAID 0138490

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