Individual provider Active NPI

Steven Cooper, LCSW

  • Clinical Social Worker
  • Dalton, GA
National Provider Identifier
1093210767
Registry record updated Oct 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
MSW008319 Issued in GA
Practice address
710 S Thornton Ave Ste F
Dalton, GA 30720-8421
Phone
(706) 934-1816
NPI assigned
Mar 26, 2018
Last updated
Oct 13, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X MSW008319 GA Primary

Addresses

Primary practice location

710 S Thornton Ave Ste F
Dalton, GA 30720-8421

Mailing address

84 Bailie LN
Chatsworth, GA 30705-7331
Phone (706) 934-1816

Other identifiers 1

IdentifierTypeStateIssuer
NAOtherGANA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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

Enrollment IDStateProvider typePAC IDDetails
I20230327000047 GA Practitioner - Clinical Social Worker 3971977323 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MSW008319GAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Modern Jane Solutions Clinical CurrentSince Nov 8, 2022 Accepting new patients
White's Pediatrics Past Accepting new patients

Locations

306 N Thornton Ave
Dalton, GA 30720
Phone (706) 310-5172

710 S Thornton Ave
Ste F
Dalton, GA 30720
Phone (404) 234-4442

Organizations & group practices 2

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": "1522022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665619200000",
    "number": "1093210767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "84 BAILIE LN",
            "city": "CHATSWORTH",
            "state": "GA",
            "postal_code": "307057331",
            "telephone_number": "706-934-1816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 S THORNTON AVE STE F",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307208421",
            "telephone_number": "706-934-1816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "STEVEN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-26",
        "last_updated": "2022-10-13",
        "certification_date": "2022-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "MSW008319",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NA",
            "identifier": "NA",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dalton, GA

Sources for this page

Verify at the official NPI Registry.