Active NPI
Sara Cooley
- Professional Counselor
- Grand Rapids, MI
National Provider Identifier
1164071601
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- Practice address
- 534 Fountain St NE
Grand Rapids, MI 49503-3422 - Phone
- (616) 456-1178
- NPI assigned
- Sep 7, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | Primary |
Addresses
Primary practice location
534 Fountain St NE
Grand Rapids, MI 49503-3422
Mailing address
6890 Byron Lakes Dr SW Apt 2a
Byron Center, MI 49315-9768
Other practice location 1
1055 Medical Park Dr SE
Grand Rapids, MI 49546-3607
Phone (616) 954-3125
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1567814400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1567814400000",
"number": "1164071601",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6890 BYRON LAKES DR SW APT 2A",
"city": "BYRON CENTER",
"state": "MI",
"postal_code": "493159768"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "534 FOUNTAIN ST NE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495033422",
"telephone_number": "616-456-1178"
}
],
"practiceLocations": [
{
"address_1": "1055 Medical Park Dr SE",
"address_purpose": "LOCATION",
"city": "Grand Rapids",
"state": "MI",
"postal_code": "495463607",
"country_code": "US",
"telephone_number": "616-954-3125",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "COOLEY",
"first_name": "SARA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-09-07",
"last_updated": "2019-09-07",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grand Rapids, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.