Provider Demographics
NPI:1447452065
Name:COOPER, JOSEPH J (PSYD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:J
Last Name:COOPER
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 CLEAR CREEK RD
Mailing Address - Street 2:
Mailing Address - City:LANGHORNE
Mailing Address - State:PA
Mailing Address - Zip Code:19047-2306
Mailing Address - Country:US
Mailing Address - Phone:215-208-4194
Mailing Address - Fax:
Practice Address - Street 1:860 LOWER FERRY RD
Practice Address - Street 2:SUITE 2
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08628-3525
Practice Address - Country:US
Practice Address - Phone:215-208-4194
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ3581103TC0700X
PA8124103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical