Individual provider Active NPI

Carrie Cooper, LPCC

  • Professional Counselor
  • Hobbs, NM
National Provider Identifier
1538238381
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
0093661 Issued in NM
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

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
46300MedicaidNM

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240229003566 UT Practitioner - Mental Health Counselor 9931446978 Reassigns benefits to 1 organization

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
Brightside Health IncGroup PAC ID 9234525098, 213 clinicians

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

LicenseStateTypeSpecialty
0093661NMMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Brightside Health, Inc. CurrentSince Feb 16, 2024 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

Verify at the official NPI Registry.