Bobby Jean Cooper

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MH 9004 Issued in FL

Practice address

12309 Breton Oak LN
Riverview, FL 33569-8227

Phone

(813) 245-5549

NPI assigned

Feb 17, 2010

Sex

Female

Sole proprietor

Yes

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

• Mrs. Bobby Jean Cooper Professional name

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Feb 17, 2010.

{
    "created_epoch": "1266364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1266364800000",
    "number": "1497077424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12309 BRETON OAK LN",
            "city": "RIVERVIEW",
            "state": "FL",
            "postal_code": "335698227",
            "telephone_number": "813-245-5549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12309 BRETON OAK LN",
            "city": "RIVERVIEW",
            "state": "FL",
            "postal_code": "335698227",
            "telephone_number": "813-245-5549"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "BOBBY",
        "middle_name": "JEAN",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-02-17",
        "last_updated": "2010-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH 9004",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BOBBY",
            "last_name": "COOPER",
            "middle_name": "JEAN",
            "prefix": "MRS.",
            "credential": "LMHC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Connections Services
• Stephanie Connel
• Camille Cook, NURSE PRACTITIONER
• Katrina Michelle Cooke, CRNA
• William Cooney
• Lakeitha Cooper
• Madison Cooper
• Toisheka Cooper, RN
• Cora Health Services, Inc.
• Angela L Corbett, LCSW, CAP

• All providers in Riverview, FL
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2010; 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.