Autumn Michelle Cooper, MBS, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

3658 Issued in OK

Practice address

405 S Washington St
Ardmore, OK 73401-7044

Phone

(580) 223-9705

Fax

(580) 223-8736

NPI assigned

Feb 12, 2007

Last updated

Dec 3, 2012By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OK

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

Specialty

Mental Health Counselor

Education

Other, 2003

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• South Central Medical and Resource Center Inc.

  • Federally Qualified Health Center (FQHC)
  • Lindsay, OK
  • NPI 1366585564
  Medicare reassignment NPD

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354492800000",
    "number": "1013059674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 S WASHINGTON ST",
            "city": "ARDMORE",
            "state": "OK",
            "postal_code": "734017044",
            "telephone_number": "580-223-9705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 S WASHINGTON ST",
            "city": "ARDMORE",
            "state": "OK",
            "postal_code": "734017044",
            "telephone_number": "580-223-9705",
            "fax_number": "580-223-8736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "AUTUMN",
        "middle_name": "MICHELLE",
        "name_prefix": "Mrs.",
        "credential": "MBS, LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-12",
        "last_updated": "2012-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OK",
            "license": "3658",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bobbie Collinsworth
• Ryllie Collinsworth
• Community Youth Services of Southern Oklahoma, Inc.
• Connie M Wilson DO PC (Wilson Loughridge)
• Tars'Jah Cook, RBT
• Franklin D Cooper II, DPM
• Robin Cooper, CCC-SLP
• Scott Allen Cooper, PA-C
• Tammey Lee Cooper, BASW
• Cornerstone Caregiving East LLC

• Professional Counselor in Ardmore, OK
• Providers in Ardmore, OK by specialty
• Professional Counselor in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2012; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.