Shaquilla N Cooper, DSW, TCM, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Practice address

1828 Bolling Ave
Louisville, KY 40210-1908

Phone

(502) 536-7245

Fax

(502) 963-5135

NPI assigned

Jun 18, 2019

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in KY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Seven Counties Services, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Louisville, KY
  • NPI 1598793671

  Clinical

  Medicare reassignment NPD
• Home Away From Home Therapeutic Center

  • Clinical Social Worker
  • Louisville, KY
  • NPI 1548035223
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1560816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727740800000",
    "number": "1003476466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1828 BOLLING AVE",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402101908",
            "telephone_number": "502-618-9205",
            "fax_number": "502-963-5135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1828 BOLLING AVE",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402101908",
            "telephone_number": "502-536-7245",
            "fax_number": "502-963-5135"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "849 S 37th St",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402112811",
            "country_code": "US",
            "telephone_number": "502-536-7245",
            "fax_number": "502-963-5135",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COOPER",
        "first_name": "SHAQUILLA",
        "middle_name": "N",
        "credential": "DSW, TCM, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-06-18",
        "last_updated": "2024-10-01",
        "certification_date": "2024-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "254214",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly Cooper, PHARMD
• Leigh Aaron Cooper, MA, LMFT
• Michael Dylan Cooper, BSN, RN
• Robert Earl Cooper, DMD
• Shannon Cooper
• Sharlene Cooper
• Tricia K Cooper, LPCC
• James L Coorssen Jr., M.D.
• Riley D Coots, MD
• Sarah Jane Coots, PTA

• Clinical Social Worker in Louisville, KY
• Providers in Louisville, KY by specialty
• Clinical Social Worker in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.