Individual provider Active NPI

Llewellyn Cooper, PH.D

  • Counselor
  • Athens, TN
National Provider Identifier
1053022897
Registry record updated Jun 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
6744 Issued in TN
Practice address
2336 Congress Pkwy S
Athens, TN 37303-2820
Phone
(423) 507-0887
NPI assigned
Dec 13, 2022
Last updated
Jun 20, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 6744 TN Primary

Addresses

Primary practice location

2336 Congress Pkwy S
Athens, TN 37303-2820

Mailing address

200 Tech Center Dr
Knoxville, TN 37912-2747
Phone (865) 637-9711

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL cooperll@monroek12.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
6744TNMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Helen Ross McNabb Center CurrentSince Jun 23, 2025 Accepting new patients

Locations

2336 Congress Pkwy S
Athens, TN 37303
Phone (423) 504-0887

200 Tech Center Dr
Knoxville, TN 37912
Phone (865) 367-9711

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1670889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750377600000",
    "number": "1053022897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 TECH CENTER DR",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379122747",
            "telephone_number": "865-637-9711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2336 CONGRESS PKWY S",
            "city": "ATHENS",
            "state": "TN",
            "postal_code": "373032820",
            "telephone_number": "423-507-0887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "LLEWELLYN",
        "credential": "PH.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-12-13",
        "last_updated": "2025-06-20",
        "certification_date": "2025-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "TN",
            "license": "6744",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "cooperll@monroek12.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1000 Green Road",
            "address_2": "Madisonville Intermediate School",
            "city": "Madisonville",
            "state": "TN",
            "country_code": "US",
            "postal_code": "37534",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Athens, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.