Individual provider Active NPI

Steven I Cooper, LCSW

  • Clinical Social Worker
  • Fairport, NY
National Provider Identifier
1679566905
Registry record updated Aug 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R038329 Issued in NY
Practice address
6800 Pittsford Palmyra Rd Ste 135
Fairport, NY 14450-3519
Phone
(585) 235-7466
Fax
(585) 424-3614
NPI assigned
Aug 23, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2024

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 R038329 NY Primary

Addresses

Primary practice location

6800 Pittsford Palmyra Rd Ste 135
Fairport, NY 14450-3519

Mailing address

6800 Pittsford Palmyra Rd Ste 135
Fairport, NY 14450-3519
Phone (585) 235-7466

Other identifiers 5

IdentifierTypeStateIssuer
MDE76ZOtherNYPREFCARE
7331361OtherAETNA
P010038329OtherNYBCBS
103743497OtherUNITED BEHAVIORAL HEALTH
2101527OtherCIGNA BEHAVIORAL HEALTH

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
I20101006000626 NY Practitioner - Clinical Social Worker 8123210317 Practice locations: Fairport, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

6800 Pittsford Palmyra Rd
BLDG 100 Suite 135
Fairport, NY 14450-3584

6800 Pittsford Palmyra Rd
Suite 135
Fairport, NY 14450-3519
Phone (585) 235-7466

6800 Pittsford Palmyra Rd BLDG 100
Suite 135
Fairport, NY 14450-3584

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R038329NYMDClinical Social Worker
038329NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Catholic Charities of the Diocese of Rochester PastSince Nov 1, 2005 Accepting new patients

Organizations & group practices 1

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": "1124755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722729600000",
    "number": "1679566905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6800 PITTSFORD PALMYRA RD STE 135",
            "city": "FAIRPORT",
            "state": "NY",
            "postal_code": "144503519",
            "telephone_number": "585-235-7466",
            "fax_number": "585-424-3614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6800 PITTSFORD PALMYRA RD STE 135",
            "city": "FAIRPORT",
            "state": "NY",
            "postal_code": "144503519",
            "telephone_number": "585-235-7466",
            "fax_number": "585-424-3614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "STEVEN",
        "middle_name": "I",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-23",
        "last_updated": "2024-08-04",
        "certification_date": "2024-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R038329",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFCARE",
            "identifier": "MDE76Z",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7331361",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "P010038329",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED BEHAVIORAL HEALTH",
            "identifier": "103743497",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA BEHAVIORAL HEALTH",
            "identifier": "2101527",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairport, NY

Sources for this page

Verify at the official NPI Registry.