Cooper, Daryl Ray

Cooper, Daryl Ray is an sole proprietor health care provider with primary practice located at 2330 Marina Dr , Klamath Falls OR 97601. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Cooper, Daryl Ray can be contacted via phone (541) 883-3471.

Contact Information

Primary practice address
2330 Marina Dr Klamath Falls OR 97601
Phone: (541) 883-3471
Fax: (541) 883-3524
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X
Behavioral Health & Social Service Providers / Clinical 1041C0700X L411 Oregon

Profile Details

NPI number 1962627844
LBN Legal business name Cooper, Daryl Ray
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 16th, 2007
Last updated Nov 16th, 2016 - 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 1962627844 NPPES
Oregon Other 026825000 BCBS PROVIDER #
Oregon MEDICAID 090450 BCBS PROVIDER #

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