Individual provider Active NPI

Merchuria Cooper

  • Clinical Social Worker
  • Los Angeles, CA
National Provider Identifier
1740598572
Registry record updated Oct 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW110335 Issued in CA
Practice address
450 Bauchet St
Los Angeles, CA 90012-2907
Phone
(323) 473-6506
NPI assigned
Sep 14, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 13, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X ACSW 72756 CA
Clinical Social Worker 1041C0700X LCSW110335 CA Primary

Addresses

Primary practice location

450 Bauchet St
Los Angeles, CA 90012-2907

Mailing address

450 Bauchet St
Los Angeles, CA 90012-2907
Phone (323) 473-6506

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20260413000276 CA Practitioner - Clinical Social Worker 6800361346 Practice locations: Los Angeles, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Los Angeles, CA 90043
Phone (818) 612-5279

3701 W Santa Roslia Dr
Suite 1060
Los Angeles, CA 90008

66 E Flagler St
Miami, FL 33130-1807

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ACSW 72756CAMDMental Health Counselor
LCSW110335CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1284422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728777600000",
    "number": "1740598572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 BAUCHET ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900122907",
            "telephone_number": "323-473-6506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 BAUCHET ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900122907",
            "telephone_number": "323-473-6506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "MERCHURIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-09-14",
        "last_updated": "2024-10-13",
        "certification_date": "2024-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "ACSW 72756",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW110335",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.