Individual provider Active NPI

Denise Michelle Cooper, LMSW

  • Social Worker
  • Poughkeepsie, NY
National Provider Identifier
1306033766
Registry record updated Oct 1, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
075355-1 Issued in NY
Practice address
46 Lincoln Ave
Poughkeepsie, NY 12601-4518
Phone
(845) 471-6004
Fax
(845) 471-7099
NPI assigned
Oct 1, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 1, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 075355-1 NY Primary

Addresses

Primary practice location

46 Lincoln Ave
Poughkeepsie, NY 12601-4518

Mailing address

46 Lincoln Ave
Poughkeepsie, NY 12601-4518
Phone (845) 471-6004

Other names 1

  • Denise Michelle Konzen Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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

Enrollment IDStateProvider typePAC IDDetails
I20140723000031 NY Order and Referring Only - Clinical Social Worker 1052537354

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
075355-1NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1191196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191196800000",
    "number": "1306033766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "46 LINCOLN AVE",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "126014518",
            "telephone_number": "845-471-6004",
            "fax_number": "845-471-7099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "46 LINCOLN AVE",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "126014518",
            "telephone_number": "845-471-6004",
            "fax_number": "845-471-7099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "DENISE",
        "middle_name": "MICHELLE",
        "name_prefix": "Ms.",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-10-01",
        "last_updated": "2007-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "075355-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DENISE",
            "last_name": "KONZEN",
            "middle_name": "MICHELLE",
            "credential": "MSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Poughkeepsie, NY

Sources for this page

Verify at the official NPI Registry.