Individual provider Active NPI

Shantel Abraham Cooper, LPC

  • Professional Counselor
  • Petersburg, VA
National Provider Identifier
1154009306
Registry record updated Aug 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
0701014999 Issued in VA
Practice address
20 E Tabb St Ste 203
Petersburg, VA 23803-4560
Phone
(804) 215-6171
NPI assigned
Jul 7, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 0701014999 VA Primary

Addresses

Primary practice location

20 E Tabb St Ste 203
Petersburg, VA 23803-4560

Mailing address

PO Box 821
Petersburg, VA 23804-0821
Phone (804) 431-4043

Other practice location 1

9201 Arboretum Pkwy
North Chesterfield, VA 23236-5402
Phone (804) 322-7188 ext. 6

Other practice location 2

84 Southgate Sq # 1199
Colonial Heights, VA 23834-3611
Phone (804) 431-4043

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0701014999VAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
The Empowerment Lab LLC Professional CurrentSince Jul 13, 2025 Accepting new patients

Locations

20 E Tabb St
Ste 203
Petersburg, VA 23803
Phone (804) 215-6171

Organizations & group practices 1

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": "1688688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755734400000",
    "number": "1154009306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 821",
            "city": "PETERSBURG",
            "state": "VA",
            "postal_code": "238040821",
            "telephone_number": "804-431-4043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 E TABB ST STE 203",
            "city": "PETERSBURG",
            "state": "VA",
            "postal_code": "238034560",
            "telephone_number": "804-215-6171"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9201 Arboretum Pkwy",
            "address_purpose": "LOCATION",
            "city": "North Chesterfield",
            "state": "VA",
            "postal_code": "232365402",
            "country_code": "US",
            "telephone_number": "804-322-7188 x6",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "84 Southgate Sq # 1199",
            "address_purpose": "LOCATION",
            "city": "Colonial Heights",
            "state": "VA",
            "postal_code": "238343611",
            "country_code": "US",
            "telephone_number": "804-431-4043",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COOPER",
        "first_name": "SHANTEL",
        "middle_name": "ABRAHAM",
        "name_prefix": "Mrs.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-07",
        "last_updated": "2025-08-21",
        "certification_date": "2025-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "0701014999",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Petersburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 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.