Paige R Cooper, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

28222 Issued in MN

Practice address

5905 Golden Valley Rd
Golden Valley, MN 55422-4463

Phone

(952) 564-0616

Fax

(952) 593-1778

NPI assigned

May 3, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1683072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683072000000",
    "number": "1134818388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5905 GOLDEN VALLEY RD",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554224463",
            "telephone_number": "952-564-0616",
            "fax_number": "952-593-1778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5905 GOLDEN VALLEY RD",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554224463",
            "telephone_number": "952-564-0616",
            "fax_number": "952-593-1778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "PAIGE",
        "middle_name": "R",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-03",
        "last_updated": "2023-05-03",
        "certification_date": "2023-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MN",
            "license": "28222",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "28222",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Courage Center
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• Courage Center

• Clinical Social Worker in Golden Valley, MN
• Providers in Golden Valley, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2023; 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.