Active NPI
Johnnie Sue Cooley, LCSW
- Clinical Social Worker
- Santa Ana, CA
National Provider Identifier
1598867566
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCS20797
- Practice address
- 405 W 5TH St
Suite 212
Santa Ana, CA 92701-4519 - Phone
- (714) 834-2125
- Fax
- (714) 568-4933
- NPI assigned
- Sep 1, 2006
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LCS20797 | CA | Primary |
Addresses
Primary practice location
405 W 5TH St
Suite 212
Santa Ana, CA 92701-4519
Mailing address
270 Cagney LN
#101
Newport Beach, CA 92663-2673
Phone (714) 480-6743
Other names 1
- Johnnie Sue Forbes
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20797 | CA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157068800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1598867566",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "270 CAGNEY LN",
"address_2": "#101",
"city": "NEWPORT BEACH",
"state": "CA",
"postal_code": "926632673",
"telephone_number": "714-480-6743",
"fax_number": "714-568-4933"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "405 W 5TH ST",
"address_2": "SUITE 212",
"city": "SANTA ANA",
"state": "CA",
"postal_code": "927014519",
"telephone_number": "714-834-2125",
"fax_number": "714-568-4933"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COOLEY",
"first_name": "JOHNNIE",
"middle_name": "SUE",
"name_prefix": "Ms.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-09-01",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "LCS20797",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "JOHNNIE",
"last_name": "FORBES",
"middle_name": "SUE",
"credential": "LCSW",
"code": "5",
"type": "Other Name"
}
]
}
Other providers in Santa Ana, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.