Candace Bryant Cooper

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LW00006516 Issued in WA

Practice address

33919 9TH Ave S Ste 209
Federal Way, WA 98003-6724

Phone

(253) 230-6123

NPI assigned

Apr 24, 2008

Last updated

Nov 8, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Candace Bryant Cooper Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Nov 8, 2021 through Nov 8, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1208995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636329600000",
    "number": "1639344260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23884",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980930884",
            "telephone_number": "253-331-5050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33919 9TH AVE S STE 209",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980036724",
            "telephone_number": "253-230-6123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRYANT COOPER",
        "first_name": "CANDACE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-24",
        "last_updated": "2021-11-08",
        "certification_date": "2021-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LW00006516",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CANDACE",
            "last_name": "COOPER",
            "middle_name": "BRYANT",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Shanavea Brown
• Tiara Brown, DMD
• Carmel P. Browne, LCSW, LICSW
• Karen Ogilvie Bryan, J.D., M.A., LMHCA
• Shannon Marie Bryan
• Adam W. Bryant, P.A.-C
• Leanne Marie Bryant, OT
• Kimberly M. Bryson, D.D.S.
• Christine Sweeney Buchanan, MA. CCC-SLP
• Kelly Mark Buchanan, LMT

• Mental Health Counselor in Federal Way, WA
• Providers in Federal Way, WA by specialty
• Mental Health Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.