Individual provider Active NPI

Marian A. Cooper, LCSW

  • Clinical Social Worker
  • Houston, TX
National Provider Identifier
1659643443
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
104193 Issued in TX
Practice address
13810 Champion Forest Dr Ste 150
Houston, TX 77069-1883
Phone
(646) 470-1820
NPI assigned
Feb 8, 2012
Last updated
Nov 27, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 084473 NY
Clinical Social Worker 1041C0700X 104193 TX Primary

Addresses

Primary practice location

13810 Champion Forest Dr Ste 150
Houston, TX 77069-1883

Mailing address

13810 Champion Forest Dr Ste 150
Houston, TX 77069-1883
Phone (646) 470-1820

Other practice location 1

1824 Madison Ave
New York, NY 10035
Phone (212) 423-4500 ext. 4554

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20170214001173 NY Practitioner - Clinical Social Worker 2769778471 Practice locations: Forest Hills, NY

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1328659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1659643443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13810 CHAMPION FOREST DR STE 150",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770691883",
            "telephone_number": "646-470-1820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13810 CHAMPION FOREST DR STE 150",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770691883",
            "telephone_number": "646-470-1820"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1824 Madison Ave",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "10035",
            "country_code": "US",
            "telephone_number": "212-423-4500 x4554",
            "fax_number": "845-256-1881",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COOPER",
        "first_name": "MARIAN",
        "middle_name": "A.",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-08",
        "last_updated": "2023-11-27",
        "certification_date": "2023-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "084473",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "104193",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.