Individual provider Active NPI

James Andrew Cooper, LADAC, CADC

  • Addiction (Substance Use Disorder) Counselor
  • Detroit, MI
National Provider Identifier
1760951925
Registry record updated May 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
2-01767 Issued in MI
Practice address
9605 Grand River Ave
Detroit, MI 48204-2139
Phone
(313) 834-5930
NPI assigned
Nov 17, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 26, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X CAD0198711 NM
Addiction (Substance Use Disorder) Counselor 101YA0400X 2-01767 MI Primary

Addresses

Primary practice location

9605 Grand River Ave
Detroit, MI 48204-2139

Mailing address

21815 Hidden Rivers Dr N
Southfield, MI 48075-1035
Phone (505) 221-4009

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
2-01767MIMDAddiction (Substance Use Disorder) Counselor
CAD0198711NMMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Nardin Park Recovery Center,Inc. CurrentSince Jun 22, 2021 Accepting new patients

Locations

9605 Grand River Ave
Detroit, MI 48204
Phone (313) 834-5930

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": "1542412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621987200000",
    "number": "1760951925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21815 HIDDEN RIVERS DR N",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480751035",
            "telephone_number": "505-221-4009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9605 GRAND RIVER AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482042139",
            "telephone_number": "313-834-5930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "JAMES",
        "middle_name": "ANDREW",
        "credential": "LADAC, CADC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-11-17",
        "last_updated": "2021-05-26",
        "certification_date": "2021-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NM",
            "license": "CAD0198711",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MI",
            "license": "2-01767",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2021; 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.