Ethan R Cooper, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

0701004381 Issued in VA

Practice address

2215 Langhorne Rd
Lynchburg, VA 24501-1121

Phone

(434) 455-3044

Fax

(434) 948-4918

NPI assigned

Jul 30, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in VA

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

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Horizon Behavioral Health

  • Community/Behavioral Health Agency
  • Lynchburg, VA
  • NPI 1871542340
  Medicare reassignment NPD

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

{
    "created_epoch": "1217376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217376000000",
    "number": "1174789119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2215 LANGHORNE RD",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245011121",
            "telephone_number": "434-455-3044",
            "fax_number": "434-948-4918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2215 LANGHORNE RD",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245011121",
            "telephone_number": "434-455-3044",
            "fax_number": "434-948-4918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "ETHAN",
        "middle_name": "R",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-30",
        "last_updated": "2008-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "0701004381",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1871542340",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• William A Cook III, M.D.
• Hailli Marie Cooke, RKT,MPH,ATS
• Cooper & Elder Optical Inc.
• Anne H Cooper, LPC
• Brittany White Cooper
• Theresa Mary Cooper, CFA, CSA
• John George Coots, ED.D, LAT, ATC
• Robin Copeland
• Elizabeth Joelle Copes, NP-C
• Haley Copper, M.ED

• Professional Counselor in Lynchburg, VA
• Providers in Lynchburg, VA by specialty
• Professional Counselor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.