Individual provider · NPI-1

Teristan Cooper, LPC

Counselor, Professional · Mableton, GA

NPI number1174133128
StatusActive
Last updated in NPPESAug 4, 2025

Details

NPI
1174133128
Entity type
Individual (NPI-1)
Name
Mr. Teristan Cooper
Credential
LPC
Sex
Male
Sole proprietor
No
Enumeration date
Aug 5, 2020
Certification date
Aug 4, 2025
Last updated
Aug 4, 2025

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
101YP2500X Counselor, ProfessionalLPC011471GAYes

Practice location

981 Regal Hills Ln
Mableton, GA 30126-7260

Phone 404-291-6596

Mailing address

3977 Covey Flush Ct Sw
Smyrna, GA 30082-3559

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