Individual provider Active NPI

Yvonne Levette Cooper, LCSW

  • Clinical Social Worker
  • Roanoke Rapids, NC
National Provider Identifier
1669779526
Registry record updated Apr 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C008057 Issued in NC
Practice address
60 NC Highway 125
Roanoke Rapids, NC 27870-6304
Phone
(252) 537-6619
Fax
(252) 308-0830
NPI assigned
Feb 11, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X C008057 NC Primary

Addresses

Primary practice location

60 NC Highway 125
Roanoke Rapids, NC 27870-6304

Mailing address

810 W Thomas St
Rocky Mount, NC 27804-5227
Phone (919) 865-8780

Other identifiers 1

IdentifierTypeStateIssuer
C008057OtherNCLCSW

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, VA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20170329002294 NC Practitioner - Clinical Social Worker 1355626664 Reassigns benefits to 1 organization
I20200108002422 VA Practitioner - Clinical Social Worker 1355626664 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C008057NCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Rha Health Services, Inc CurrentSince Apr 2, 2018 Accepting new patients
Rha Health Services Inc Current Accepting new patients
Southside Behavioral Health Clinical CurrentSince Nov 1, 2019 Accepting new patients
Rha Health Services, Inc. CurrentSince Apr 2, 2018 Accepting new patients

Locations

211 Perimeter Center Pkwy NE
Ste 750
Atlanta, GA 30346

1819 Peachtree Rd NE
Ste 450
Atlanta, GA 30309
Phone (910) 332-5734

211 S Centennial St
High Point, NC 27260
Phone (336) 841-0143

60 NC Highway 125
Roanoke Rapids, NC 27870
Phone (252) 537-6619

Organizations & group practices 4

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": "1297382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523318400000",
    "number": "1669779526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "810 W THOMAS ST",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "278045227",
            "telephone_number": "919-865-8780",
            "fax_number": "919-865-8781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 NC HIGHWAY 125",
            "city": "ROANOKE RAPIDS",
            "state": "NC",
            "postal_code": "278706304",
            "telephone_number": "252-537-6619",
            "fax_number": "252-308-0830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "YVONNE",
        "middle_name": "LEVETTE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-02-11",
        "last_updated": "2018-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C008057",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LCSW",
            "identifier": "C008057",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roanoke Rapids, NC

Sources for this page

Verify at the official NPI Registry.