MRS. BETHANY LANAE' COOPER (PSYD) – Clinical Child & Adolescent Psychologist, NPI 1033752894
Clinical Child & Adolescent Psychologist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,139 CLINICAL PSYCHOLOGIST in OH
Provider Addresses for MRS. BETHANY LANAE' COOPER (PSYD)
204 Patrick Ave
Urbana, OH 430782302
Phone: (937) 484-6157
Fax: (937) 484-6181
Type: Location
2037 SIDNEYWOOD DR APT B
WEST CARROLLTON, OH 454492634
Phone:
Type: Mailing
3333 W Tech Rd Ste 220
Miamisburg, OH 453420956
Phone: (937) 748-6116
Fax: (937) 291-6956
Type: Location
1 Childrens Plz
Dayton, OH 454041815
Phone: (937) 641-3401
Fax: (937) 641-3046
Type: Location
9000 N Main St Ste 332
Englewood, OH 454151185
Phone: (937) 832-7337
Fax: (937) 832-4817
Type: Location
5501 Far Hills Ave Ste 200
Dayton, OH 454292203
Phone: (937) 436-2866
Fax: (937) 436-1468
Type: Location
1425 N Fairfield Rd Ste 130
Beavercreek, OH 454322674
Phone: (937) 320-1950
Fax: (937) 320-9332
Type: Location
1010 Valley St
Dayton, OH 454042070
Phone: (937) 641-3401
Fax: (937) 641-3046
Type: Location
1640 N Limestone St
Springfield, OH 455032652
Phone: (937) 328-2320
Fax: (937) 328-2349
Type: Location
PO BOX 933421
CLEVELAND, OH 441930039
Phone: (937) 641-5072
Fax: (937) 641-6129
Type: Mailing
Edwin C. Moses Boulevard, Dayton, Montgomery County, Ohio, 45422, United States
DAYTON, OH 454028470
Phone: (937) 775-4300
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2025-07-30
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20250730001570 | I | Clinical Psychologist | OH | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 43078)
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