Individual provider Active NPI

Kelsey Diana Cooper, LCSW

  • Clinical Social Worker
  • Carlsbad, CA
National Provider Identifier
1508573650
Registry record updated Oct 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
108935 Issued in CA
Practice address
357 Chestnut Ave Apt 26
Carlsbad, CA 92008-3120
Phone
(858) 248-2583
NPI assigned
Oct 28, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 28, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 108935 CA Primary

Addresses

Primary practice location

357 Chestnut Ave Apt 26
Carlsbad, CA 92008-3120

Mailing address

357 Chestnut Ave Apt 26
Carlsbad, CA 92008-3120
Phone (858) 248-2583

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
108935CAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1666915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666915200000",
    "number": "1508573650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "357 CHESTNUT AVE APT 26",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "920083120",
            "telephone_number": "858-248-2583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "357 CHESTNUT AVE APT 26",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "920083120",
            "telephone_number": "858-248-2583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "KELSEY",
        "middle_name": "DIANA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-10-28",
        "last_updated": "2022-10-28",
        "certification_date": "2022-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "108935",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carlsbad, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2022; 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.