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:
Health care specialties
Specialty | Code | License # | 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 8 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1962627844 | NPPES |
Oregon | Other | 026825000 | BCBS PROVIDER # |
Oregon | MEDICAID | 090450 | BCBS PROVIDER # |
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