Provider Demographics
NPI:1679566905
Name:COOPER, STEVEN I (LCSW)
Entity type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:I
Last Name:COOPER
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6800 PITTSFORD PALMYRA RD STE 135
Mailing Address - Street 2:
Mailing Address - City:FAIRPORT
Mailing Address - State:NY
Mailing Address - Zip Code:14450-3519
Mailing Address - Country:US
Mailing Address - Phone:585-235-7466
Mailing Address - Fax:585-424-3614
Practice Address - Street 1:6800 PITTSFORD PALMYRA RD STE 135
Practice Address - Street 2:
Practice Address - City:FAIRPORT
Practice Address - State:NY
Practice Address - Zip Code:14450-3519
Practice Address - Country:US
Practice Address - Phone:585-235-7466
Practice Address - Fax:585-424-3614
Is Sole Proprietor?:No
Enumeration Date:2005-08-23
Last Update Date:2024-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0383291041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYMDE76ZOtherPREFCARE
7331361OtherAETNA
NYP010038329OtherBCBS
103743497OtherUNITED BEHAVIORAL HEALTH
2101527OtherCIGNA BEHAVIORAL HEALTH
NYP010038329OtherBCBS
103743497OtherUNITED BEHAVIORAL HEALTH