Individual provider Active NPI

Victoria Lyn Cooper, LCSW

  • Clinical Social Worker
  • Saint Louis, MO
National Provider Identifier
1104128354
Registry record updated Nov 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
004978 Issued in MO
Practice address
8390 Delmar Blvd
Suite 210
Saint Louis, MO 63124-2117
Phone
(314) 692-9010
Fax
(314) 692-9014
NPI assigned
Nov 20, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2010

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 004978 MO Primary

Addresses

Primary practice location

8390 Delmar Blvd
Suite 210
Saint Louis, MO 63124-2117

Mailing address

8390 Delmar Blvd
Suite 210
Saint Louis, MO 63124-2117
Phone (314) 692-9010

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20110103000960 MO Practitioner - Clinical Social Worker 9234327404 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1995
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

14561 N Outer 40
Suite 250
Chesterfield, MO 63017-5703

14561 N Outer 40 Rd
Suite 250
Chesterfield, MO 63017-5703

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
004978MOMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Monarch Immigrant Services Clinical PastSince Sep 15, 2012 Accepting new patients
Thomas J. Lantsberger, PH.D. LLC Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1290211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1290211200000",
    "number": "1104128354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8390 DELMAR BLVD",
            "address_2": "SUITE 210",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631242117",
            "telephone_number": "314-692-9010",
            "fax_number": "314-692-9014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8390 DELMAR BLVD",
            "address_2": "SUITE 210",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631242117",
            "telephone_number": "314-692-9010",
            "fax_number": "314-692-9014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "VICTORIA",
        "middle_name": "LYN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-20",
        "last_updated": "2010-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "004978",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.