Staci Cooper, LCPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LCPC-4487 Issued in ID

Practice address

410 S Orchard St. Ste 140
Boise, ID 83705-1288

Phone

(986) 686-6548

Fax

(844) 845-7650

NPI assigned

Sep 26, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1222387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713830400000",
    "number": "1629228663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 S ORCHARD ST. STE 140",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837051288",
            "telephone_number": "503-314-7435",
            "fax_number": "844-845-7650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 S ORCHARD ST. STE 140",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837051288",
            "telephone_number": "986-686-6548",
            "fax_number": "844-845-7650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "STACI",
        "credential": "LCPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-26",
        "last_updated": "2024-04-23",
        "certification_date": "2024-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "ID",
            "license": "LCPC-4487",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hayden Cooper
• Jonah Cooper
• Lauren Marissa Cooper, MD
• Lynzi Cooper
• Robert M Cooper, MD
• Suzette M Cooper, PHARMD
• Jaclyn Marie Cooperrider, MD
• Matthew Coopersmith, PSYD
• Copper Sun Counseling
• Jesse George Cops, ATC, LAT

• Mental Health Counselor in Boise, ID
• Providers in Boise, ID by specialty
• Mental Health Counselor in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.