Individual provider Active NPI

Andrea Cooper, MS, LCMHC

  • Mental Health Counselor
  • Jacksonville, NC
National Provider Identifier
1144092073
Registry record updated Oct 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
18705 Issued in NC
Practice address
3886 Henderson Dr
Jacksonville, NC 28546-5219
Phone
(910) 938-9833
NPI assigned
Oct 24, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 18705 NC Primary

Addresses

Primary practice location

3886 Henderson Dr
Jacksonville, NC 28546-5219

Mailing address

3886 Henderson Dr
Jacksonville, NC 28546-5219
Phone (910) 938-9833

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20251121002723 NC Practitioner - Mental Health Counselor 6103318761 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2019
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2416 Bedgood Dr SW
Wilson, NC 27893-8515

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Master of Science - Law

State licenses

LicenseStateTypeSpecialty
18705NCMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Pride in North Carolina, LLC Mental Health CurrentSince Oct 24, 2025 Accepting new patients
Pride in North Carolina, LLC Mental Health CurrentSince Oct 24, 2025 Accepting new patients

Locations

231 Commerce St
Greenville, NC 27858
Phone (252) 321-8080

3886 Henderson Dr
Jacksonville, NC 28546
Phone (910) 938-9833

5710 Oleander Dr
Ste 112
Wilmington, NC 28403
Phone (910) 769-1785

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1698105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761264000000",
    "number": "1144092073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3886 HENDERSON DR",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285465219",
            "telephone_number": "910-938-9833",
            "fax_number": "910-938-9835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3886 HENDERSON DR",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285465219",
            "telephone_number": "910-938-9833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "ANDREA",
        "credential": "MS, LCMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-10-24",
        "last_updated": "2025-10-24",
        "certification_date": "2025-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "18705",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, NC

Sources for this page

Verify at the official NPI Registry.