person
Dr. Gordon Kenneth Cooper, PHD
Mental Health Counselor in Providence, Rhode Island
NPI 1144259151

Gordon Kenneth Cooper is a Mental Health Counselor based in Johnston, RI and is specialized in Mental Health. Gordon Kenneth Cooper practices in Providence, RI and has the professional credentials of PHD. The NPI Number for Gordon Kenneth Cooper is 1144259151 and holds a License No. LCDP00013 (Rhode Island).

The current practice location address for Gordon Kenneth Cooper is 55 Hope St, Providence, RI and can be reached out via phone at 401-331-1350 and via fax at 401-277-3366. You can also correspond with Gordon Kenneth Cooper through the mailing address at 434 GREENVILLE AVE, JOHNSTON, RI - 02919-2224 (mailing address contact number: 401-331-1350).

Location: 55 Hope St, Providence, RI, 02919-2224
person
Provider Profile Details
NPI Number
1144259151
Provider Name
Gordon Kenneth Cooper
Credential
PHD
Provider Entity Type
Individual
Gender
Male
Address
55 Hope St, Providence, RI, 02919-2224
Phone Number
401-331-1350
Fax Number
401-277-3366
Provider Enumeration Date
07/02/2006
Last Update Date
03/08/2024
tick
Provider's Legacy Identifiers
Identifier Type State Issuer
089590 01 VALUE OPTIONS
2195772 01 AETNA
7855-9 01 BLUE CROSS/BLUE SHIELD
62-10104 01 UNITED BEHAVIORAL HEALTH
GC02929 05 RI
407027 01 BLUE CHIP
institution
Provider Business Practice Location Address Details
Address
55 Hope St
City
State
Zip
02906-2001
Phone Number
401-331-1350
Fax Number
401-277-3366
person
Provider Business Mailing Address Details
Address
434 Greenville Ave
City
State
Zip
02919-2224
Phone Number
401-331-1350
Fax Number
401-277-3366
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
License No.
MHC00086 (Rhode Island)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
License No.
LCDP00013 (Rhode Island)
Definition
Definition to come...
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