Individual provider · Type 1 NPI
Jacquelyn Marie Cooper, LADAC II
Addiction (Substance Use Disorder) Counselor · Cleveland, TN
NPI number
1679460745
Active
Practice location
1510 Stuart Rd NE Ste 101
Cleveland, TN 37312-5869
Mailing address
1809 Forest Ridge Dr SW
Cleveland, TN 37311-7321
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Addiction (Substance Use Disorder) Counselor Primary | 101YA0400X | 1730 (TN) |
Addiction (Substance Use Disorder) Counselor: Definition to come...
2 other providers at this address
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About NPI 1679460745
Jacquelyn Marie Cooper, LADAC II's National Provider Identifier is 1679460745, issued on Jun 21, 2025. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Cleveland, TN. The record was last updated on Jun 21, 2025.