Individual provider Active NPI

Elizabeth Cooper, LMSW

  • Social Worker
  • Center Moriches, NY
National Provider Identifier
1689401333
Registry record updated Sep 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
124942-01 Issued in NY
Practice address
234 Main St
Center Moriches, NY 11934-3514
Phone
(631) 874-0185
NPI assigned
Sep 17, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 124942-01 NY Primary

Addresses

Primary practice location

234 Main St
Center Moriches, NY 11934-3514

Mailing address

234 Main St
Center Moriches, NY 11934-3514
Phone (631) 874-0185

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
124942-01NYMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Qureshi Medical Services PLLC CurrentSince Dec 1, 2024 Accepting new patients
Community Counseling & LCSW Services PC CurrentSince Sep 23, 2024 Accepting new patients

Locations

234 Montauk Hwy
Ctr Moriches, NY 11934
Phone (631) 874-0185

Organizations & group practices 2

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": "1726531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727222400000",
    "number": "1689401333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "234 MAIN ST",
            "city": "CENTER MORICHES",
            "state": "NY",
            "postal_code": "119343514",
            "telephone_number": "631-874-0185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "234 MAIN ST",
            "city": "CENTER MORICHES",
            "state": "NY",
            "postal_code": "119343514",
            "telephone_number": "631-874-0185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "ELIZABETH",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-17",
        "last_updated": "2024-09-25",
        "certification_date": "2024-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "124942-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Center Moriches, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2024; 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.