Individual provider Active NPI

Carolyn M Cooper, LPC

  • Counselor
  • Fairbanks, AK
National Provider Identifier
1366757106
Registry record updated May 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
240969 Issued in AK
Practice address
3401 Peger Rd Ste C
Fairbanks, AK 99709-5488
Phone
(907) 374-7076
Fax
(907) 374-7078
NPI assigned
Aug 17, 2010
Last updated
May 31, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 31, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 240969 AK Primary

Addresses

Primary practice location

3401 Peger Rd Ste C
Fairbanks, AK 99709-5488

Mailing address

3401 Peger Rd Ste C
Fairbanks, AK 99709-5488
Phone (907) 374-7076

Other identifiers 1

IdentifierTypeStateIssuer
MH0157MedicaidAK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK
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
I20260106000985 AK Practitioner - Mental Health Counselor 1557897261 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Greater Works Caring CenterGroup PAC ID 0648706358, 3 clinicians

Practice addresses (Care Compare)

3401 Peger Rd
Suite C
Fairbanks, AK 99709-5488
Phone (907) 374-7076

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
240969AKMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Greater Works Caring Center Counselor CurrentSince Oct 31, 2024 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1282003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780185600000",
    "number": "1366757106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3401 PEGER RD STE C",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997095488",
            "telephone_number": "907-374-7076",
            "fax_number": "907-374-7078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 PEGER RD STE C",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997095488",
            "telephone_number": "907-374-7076",
            "fax_number": "907-374-7078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "CAROLYN",
        "middle_name": "M",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-08-17",
        "last_updated": "2026-05-31",
        "certification_date": "2026-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "AK",
            "license": "240969",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MH0157",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairbanks, AK

Sources for this page

Verify at the official NPI Registry.