Mallory Christine Cooper

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SP3893 Issued in ME

Practice address

589 Minot Ave
Auburn, ME 04210-4032

Phone

(207) 443-3341

Fax

(207) 777-1205

NPI assigned

May 15, 2023

Last updated

May 16, 2023By 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 2

Addresses

Medicare fee-for-service enrollment

Enrolled in ME

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

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.

• Pine Tree Society Inc

  • Voluntary or Charitable Agency
  • Bath, ME
  • NPI 1124032347
  Medicare reassignment NPD
• Pathways, Inc.

  • Case Management Agency
  • Auburn, ME
  • NPI 1598841603
  NPD (past)

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

{
    "created_epoch": "1684108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684195200000",
    "number": "1033800701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "905 1/2 N RANDOLPH ST",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618202938",
            "telephone_number": "217-620-2950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "589 MINOT AVE",
            "city": "AUBURN",
            "state": "ME",
            "postal_code": "042104032",
            "telephone_number": "207-443-3341",
            "fax_number": "207-777-1205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "MALLORY",
        "middle_name": "CHRISTINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-15",
        "last_updated": "2023-05-16",
        "certification_date": "2023-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "ME",
            "license": "SP3893",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paula Connor-Crouch, LCSW
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• Convenientmd LLC
• Tracy Lynn Corey, LCPC
• Mary Elizabeth Cote, RPH
• Cynthia M Cotton, LCPC
• Ellen Marie County
• Courtney Dostie (Kornerstone Home Care)

• Speech-Language Pathologist in Auburn, ME
• Providers in Auburn, ME by specialty
• Speech-Language Pathologist in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.