Active NPI
Cooper Counseling and Therapy Services, PLLC
- Community/Behavioral Health Agency
- Charlotte, NC
National Provider Identifier
1265104434
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Behavioral Health Agency
- Legal business name
- COOPER COUNSELING AND THERAPY SERVICES, PLLC
- Practice address
- 6047 Tyvola Glen Cir Ste 211
Charlotte, NC 28217-6437 - Phone
- (980) 900-9574
- Fax
- (704) 780-1066
- NPI assigned
- Oct 5, 2021
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ms. Carman Vatrell Cooper, LCSW
- Title
- Owner
- Phone
- (980) 900-9574
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | |||
| Community/Behavioral Health Agency | 251S00000X | Primary | ||
| Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility | 320900000X |
Addresses
Primary practice location
6047 Tyvola Glen Cir Ste 211
Charlotte, NC 28217-6437
Mailing address
10109 Glenburn LN
Charlotte, NC 28278-6001
Phone (980) 900-9574
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC, SC
Enrollment records 2
National Provider Directory
National Provider DirectoryLocations
6047 Tyvola Glen Cir
Ste 211
Charlotte, NC 28217
Phone (980) 900-9574
1327 Crawford Rd
Rock Hill, SC 29730
Phone (980) 900-9574
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1633392000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1738022400000",
"number": "1265104434",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10109 GLENBURN LN",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282786001",
"telephone_number": "980-900-9574",
"fax_number": "704-780-1066"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6047 TYVOLA GLEN CIR STE 211",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282176437",
"telephone_number": "980-900-9574",
"fax_number": "704-780-1066"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "COOPER COUNSELING AND THERAPY SERVICES, PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2021-10-05",
"last_updated": "2025-01-28",
"certification_date": "2025-01-28",
"status": "A",
"authorized_official_last_name": "COOPER",
"authorized_official_first_name": "CARMAN",
"authorized_official_middle_name": "VATRELL",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "980-900-9574",
"authorized_official_name_prefix": "Ms.",
"authorized_official_credential": "LCSW"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"primary": false
},
{
"code": "251S00000X",
"taxonomy_group": "",
"desc": "Community/Behavioral Health",
"state": null,
"license": null,
"primary": true
},
{
"code": "320900000X",
"taxonomy_group": "",
"desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.