Individual provider Active NPI

Shannon Cooper, LMSW

  • Social Worker
  • Rosedale, MD
National Provider Identifier
1104499078
Registry record updated Jul 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
22721 Issued in MD
Practice address
9627 Philadelphia Rd Ste 160
Rosedale, MD 21237-4157
Phone
(410) 780-5203
NPI assigned
Jul 20, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 22721 MD Primary

Addresses

Primary practice location

9627 Philadelphia Rd Ste 160
Rosedale, MD 21237-4157

Mailing address

9627 Philadelphia Rd Ste 160
Rosedale, MD 21237-4157
Phone (410) 780-5203

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20251103000844 MD Practitioner - Clinical Social Worker 9032608690 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2015
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4318 Lord Fairfax CT
Upper Marlboro, MD 20772-5919

9627 Philadelphia Rd
Suite 160
Rosedale, MD 21237-4154

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22721MDMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Thrive Behavioral Health, LLC CurrentSince Oct 1, 2025 Accepting new patients
Thrive Behavioral Health, LLC CurrentSince Oct 1, 2025 Accepting new patients
Thrive Behavioral Health, LLC Current Accepting new patients

Locations

1114 Benfield Blvd
Ste G
Millersville, MD 21108
Phone (410) 780-4320

9627 Philadelphia Rd
Ste 160
Rosedale, MD 21237
Phone (410) 780-5205

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": "1626739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626739200000",
    "number": "1104499078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9627 PHILADELPHIA RD STE 160",
            "city": "ROSEDALE",
            "state": "MD",
            "postal_code": "212374157",
            "telephone_number": "410-780-5203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9627 PHILADELPHIA RD STE 160",
            "city": "ROSEDALE",
            "state": "MD",
            "postal_code": "212374157",
            "telephone_number": "410-780-5203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "SHANNON",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-20",
        "last_updated": "2021-07-20",
        "certification_date": "2021-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MD",
            "license": "22721",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rosedale, MD

Sources for this page

Verify at the official NPI Registry.