Active NPI
Carrie Cooper, LPCC
- Professional Counselor
- Hobbs, NM
National Provider Identifier
1538238381
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 0093661
- Practice address
- 920 W Broadway St
Hobbs, NM 88240-5529 - Phone
- (505) 393-3168
- Fax
- (505) 397-4659
- NPI assigned
- Nov 7, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 0093661 | NM | Primary |
Addresses
Primary practice location
920 W Broadway St
Hobbs, NM 88240-5529
Mailing address
920 W Broadway St
Hobbs, NM 88240-5529
Phone (505) 393-3168
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 46300 | Medicaid | NM |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in UT
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 2001
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
3556 S 5600
1 828
Salt Lake City, UT 84120-2815
Phone (415) 360-3348
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0093661 | NM | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Brightside Health, Inc. | Current | Accepting new patients |
Locations
2261 Market St
San Francisco, CA 94114
Phone (213) 337-4615
3556 S 5600 W
#1828
West Valley City, UT 84120
Phone (330) 416-3867
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": "1162857600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1538238381",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "920 W BROADWAY ST",
"city": "HOBBS",
"state": "NM",
"postal_code": "882405529",
"telephone_number": "505-393-3168",
"fax_number": "505-397-4659"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "920 W BROADWAY ST",
"city": "HOBBS",
"state": "NM",
"postal_code": "882405529",
"telephone_number": "505-393-3168",
"fax_number": "505-397-4659"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COOPER",
"first_name": "CARRIE",
"credential": "LPCC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-07",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "NM",
"license": "0093661",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "46300",
"state": "NM"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Hobbs, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.