Provider Demographics
NPI:1871979971
Name:CARLA J. COOPER
Entity type:Organization
Organization Name:CARLA J. COOPER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TCM
Authorized Official - Prefix:MRS
Authorized Official - First Name:CARLA
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:COOPER
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:913-209-8621
Mailing Address - Street 1:16216 S AVALON ST
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66062-3143
Mailing Address - Country:US
Mailing Address - Phone:913-209-8621
Mailing Address - Fax:866-771-0071
Practice Address - Street 1:16216 S AVALON ST
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66062-3143
Practice Address - Country:US
Practice Address - Phone:913-209-8621
Practice Address - Fax:866-771-0071
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-31
Last Update Date:2015-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management