Shenell Cooper, MSW

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

0710102482 Issued in VA

Practice address

3001 Churchland Blvd
Chesapeake, VA 23321-5603

Phone

(757) 977-9675

Fax

(757) 483-8099

NPI assigned

Jan 28, 2021

Last updated

Jan 29, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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.

• Tidewater Mobile Medicine, PLLC

  dba Authentic Self Counseling Services

  • Family Medicine Physician
  • Portsmouth, VA
  • NPI 1225527351

  Addiction (Substance Use Disorder)

  NPD

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

{
    "created_epoch": "1611792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611878400000",
    "number": "1174114524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3001 CHURCHLAND BLVD",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233215603",
            "telephone_number": "757-977-9675",
            "fax_number": "757-483-8099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 CHURCHLAND BLVD",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233215603",
            "telephone_number": "757-977-9675",
            "fax_number": "757-483-8099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "SHENELL",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-28",
        "last_updated": "2021-01-29",
        "certification_date": "2021-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "VA",
            "license": "0710102482",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hannah Elizabeth Cooper
• Jessica R Cooper, LPC
• Kevin C Cooper, D.D.S.
• Saeed Cooper
• Sarah Cooper, OD
• Coopers Transport LLC
• Asia Nachante Copeland
• Crystal Copeland, LPC
• John S. Copeland, LPC
• Kacey L Copeland

• Addiction (Substance Use Disorder) Counselor in Chesapeake, VA
• Providers in Chesapeake, VA by specialty
• Addiction (Substance Use Disorder) Counselor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2021; 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.