Stacey M Cooper-Jennings, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

11098 Issued in MA

Practice address

60 Merrimack St
Haverhill, MA 01830-6207

Phone

(978) 373-1126

Fax

(978) 373-6363

NPI assigned

Jan 1, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Miss Stacey M Cooper Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Northeast Behavioral Health Corporation

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Beverly, MA
  • NPI 1154302586
  NPD (past)

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

{
    "created_epoch": "1167609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1679639702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "74 PACKERS FALLS RD",
            "city": "NEWMARKET",
            "state": "NH",
            "postal_code": "038571008",
            "telephone_number": "603-659-6137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 MERRIMACK ST",
            "city": "HAVERHILL",
            "state": "MA",
            "postal_code": "018306207",
            "telephone_number": "978-373-1126",
            "fax_number": "978-373-6363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER-JENNINGS",
        "first_name": "STACEY",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "11098",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NH",
            "license": "1098",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1312294",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACEY",
            "last_name": "COOPER",
            "middle_name": "M",
            "prefix": "MISS",
            "credential": "LICSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ryan Connors
• Walson Constant, THERAPEUTICMENTORING
• Contemporary Counseling and Wellness
• Debra Coviello Cook, RN
• Kimberley Beth Cook, OTR
• Core Physician Services of Massachusetts Inc
• Cornerstone Caregiving East LLC
• Sara J Correia
• Christa Corricelli, MS, M.ED.
• Kaylee Cortes

• Clinical Social Worker in Haverhill, MA
• Providers in Haverhill, MA by specialty
• Clinical Social Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.