Basic Information
| Provider Information | |||||||||
| NPI: | 1790819092 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | COOPEY | ||||||||
| FirstName: | BETH | ||||||||
| MiddleName: | ARLENE | ||||||||
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| Credential: | LSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7800A STENTON AVENUE | ||||||||
| Address2: | #102 | ||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 19118 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2157539211 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | COATESVILLE VA MEDICAL CENTER | ||||||||
| Address2: | 1400 BLACKHORSE HILL ROAD | ||||||||
| City: | COATESVILLE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 19320 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6103847711 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/16/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 104100000X | SW125085 | PA | Y | Behavioral Health & Social Service Providers | Social Worker |
No ID Information.