Nicole Coopersmith

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

IMT4415 Issued in FL

Practice address

12333 NW 18TH St Ste 5
Pembroke Pines, FL 33026-4386

Phone

(954) 780-6093

Fax

(954) 206-5764

NPI assigned

Sep 16, 2025

Last updated

Sep 16, 2025By 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Monterroso Integrative Services, Inc

  • Behavior Analyst
  • Pembroke Pines, FL
  • NPI 1780195990
  NPD

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

{
    "created_epoch": "1757980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757980800000",
    "number": "1104797794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1460 S OCEAN BLVD APT 1503",
            "city": "POMPANO BEACH",
            "state": "FL",
            "postal_code": "330622708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12333 NW 18TH ST STE 5",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330264386",
            "telephone_number": "954-780-6093",
            "fax_number": "954-206-5764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPERSMITH",
        "first_name": "NICOLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-09-16",
        "last_updated": "2025-09-16",
        "certification_date": "2025-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": "FL",
            "license": "IMT4415",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Conviva Medical Center Management LLC
• Tangela Cooke
• Brian Cooper
• Marissa Nicole Cooper, D.M.D.
• Sheena Christine Cooper, LCSW
• Cora Health Services Inc (CORA Physical Therapy - East Pembroke Pines)
• Cora Health Services Inc (CORA Physical Therapy - West Pembroke Pines)
• Coral Reef Home Health Solutions LLC
• Coral Reef Home Health Solutions LLC
• Corbelle Dental Care

• Behavior Analyst in Pembroke Pines, FL
• Providers in Pembroke Pines, FL by specialty
• Behavior Analyst in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 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.