Jacob Leib Cooper, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

089558 Issued in NY

Practice address

445 Oak St
Copiague, NY 11726-3111

Phone

(718) 845-2621

NPI assigned

Sep 9, 2020

Last updated

Sep 9, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1599609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599609600000",
    "number": "1386259190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "445 OAK ST",
            "city": "COPIAGUE",
            "state": "NY",
            "postal_code": "117263111",
            "telephone_number": "718-845-2621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "445 OAK ST",
            "city": "COPIAGUE",
            "state": "NY",
            "postal_code": "117263111",
            "telephone_number": "718-845-2621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "JACOB",
        "middle_name": "LEIB",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-09-09",
        "last_updated": "2020-09-09",
        "certification_date": "2020-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "089558",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "newyork",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "newyork",
            "address_1": "10819 Rockaway Blvd",
            "city": "South Ozone Park",
            "state": "NY",
            "country_code": "US",
            "postal_code": "114201034",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "newyork",
            "affiliation": "N",
            "address_1": "10819 Rockaway Blvd",
            "city": "South Ozone Park",
            "state": "NY",
            "country_code": "US",
            "postal_code": "114201034",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Tiffany A Contreras, MSW
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• Copiague Public School
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• Clinical Social Worker in Copiague, NY
• Providers in Copiague, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2020; 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.