Mary Coonan, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW13239 Issued in FL

Practice address

126 S Cypress Rd
Apt 738
Pompano Beach, FL 33060-7056

Phone

(917) 575-6880

NPI assigned

May 21, 2007

Last updated

Aug 27, 2017By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Postgraduate Center for Mental Health

  • Community/Behavioral Health Agency
  • New York, NY
  • NPI 1629127725
  NPD (past)

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

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1503792000000",
    "number": "1083823579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "126 S CYPRESS RD",
            "address_2": "APT 738",
            "city": "POMPANO BEACH",
            "state": "FL",
            "postal_code": "330607056",
            "telephone_number": "917-575-6880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "126 S CYPRESS RD",
            "address_2": "APT 738",
            "city": "POMPANO BEACH",
            "state": "FL",
            "postal_code": "330607056",
            "telephone_number": "917-575-6880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COONAN",
        "first_name": "MARY",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-21",
        "last_updated": "2017-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW13239",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER TAXONOMY CODE",
            "identifier": "1041C0700X",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LCSW LICENSDCLINCALSOCWKR",
            "identifier": "072106",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Continued Sobriety LLC
• Daniela Contreras, PA
• Kristina Marie Contreras
• Conviva Medical Center Management LLC
• Conviva Medical Center Management LLC
• Earnestine Cooper
• Neva Michelle Cooper
• Patricia Michelle Cooper, LCSW
• Anna Marie Fatima Cootauco
• Marie Coote, PMHNP-BC

• Clinical Social Worker in Pompano Beach, FL
• Providers in Pompano Beach, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2017; 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.