Channon Cooper LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

CHANNON COOPER LLC

Practice address

4390 E Baltimore Ave
Las Vegas, NV 89104-5304

Phone

(702) 449-3705

NPI assigned

Jan 5, 2024

Last updated

Jan 5, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Channon CooperNPI 1497015929

Title

Owner

Phone

(702) 349-2705

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Channon Cooper

  • Counselor
  • Las Vegas, NV
  • NPI 1497015929
  NPD Authorized official

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

{
    "created_epoch": "1704412800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704412800000",
    "number": "1396515813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4390 E BALTIMORE AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891045304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4390 E BALTIMORE AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891045304",
            "telephone_number": "702-449-3705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHANNON COOPER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-05",
        "last_updated": "2024-01-05",
        "certification_date": "2024-01-05",
        "status": "A",
        "authorized_official_last_name": "COOPER",
        "authorized_official_first_name": "CHANNON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "702-349-2705"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community/Behavioral Health Agency in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Community/Behavioral Health Agency in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2024; 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.