Basic Information
| Provider Information | |||||||||
| NPI: | 1669034674 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | COPELAND-COOK | ||||||||
| FirstName: | MERRI | ||||||||
| MiddleName: | ELIZABETH | ||||||||
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| Credential: | MS, LPC, NCC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 207 BRANCH ST | ||||||||
| Address2: | |||||||||
| City: | BONNE TERRE | ||||||||
| State: | MO | ||||||||
| PostalCode: | 636281807 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5738809449 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2855 TELEGRAPH AVE STE 515 | ||||||||
| Address2: | |||||||||
| City: | BERKELEY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 947051151 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5103454379 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/01/2019 | ||||||||
| LastUpdateDate: | 10/27/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/27/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | 2019021899 | MO | Y | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.