Individual provider Active NPI

Shawna Rae Cooper, LMSW

  • Social Worker
  • Ames, IA
National Provider Identifier
1477242006
Registry record updated May 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
076888 Issued in IA
Practice address
614 Billy Sunday Rd Ste 100
Ames, IA 50010-8048
Phone
(515) 337-1764
Fax
(515) 337-0480
NPI assigned
May 1, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 1, 2023

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 076888 IA Primary

Addresses

Primary practice location

614 Billy Sunday Rd Ste 100
Ames, IA 50010-8048

Mailing address

1616 NE Meadow CT
Ankeny, IA 50021-2505
Phone (515) 571-4877

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
076888IAMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Clear Brook Counseling Professionals, LLC CurrentSince Jun 1, 2024 Accepting new patients

Locations

614 Billy Sunday Rd
Ste 100
Ames, IA 50010
Phone (515) 337-0480

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1682899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682899200000",
    "number": "1477242006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1616 NE MEADOW CT",
            "city": "ANKENY",
            "state": "IA",
            "postal_code": "500212505",
            "telephone_number": "515-571-4877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "614 BILLY SUNDAY RD STE 100",
            "city": "AMES",
            "state": "IA",
            "postal_code": "500108048",
            "telephone_number": "515-337-1764",
            "fax_number": "515-337-0480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "SHAWNA",
        "middle_name": "RAE",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-05-01",
        "last_updated": "2023-05-01",
        "certification_date": "2023-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IA",
            "license": "076888",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ames, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2023; 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.