Krystal Marysa Cooper, LGMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

Practice address

6440 Dobbin Rd Ste D
Columbia, MD 21045-4770

Phone

(410) 730-2385

NPI assigned

Nov 27, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

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

Specialty

Marriage and Family Therapist

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Northeast Health Services LLCGroup PAC ID 6901866706, 470 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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 Health Services, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Taunton, MA
  • NPI 1225067481
  Medicare reassignment Care Compare group NPD
• MPB Group Inc

  • Community/Behavioral Health Agency
  • Bowie, MD
  • NPI 1407200017
  NPD
• MPB Group Inc

  • Community/Behavioral Health Agency
  • Columbia, MD
  • NPI 1649473026
  NPD (past)

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

{
    "created_epoch": "1701043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1770359275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6716 COZY LN",
            "city": "ELKRIDGE",
            "state": "MD",
            "postal_code": "210755825",
            "telephone_number": "301-395-0148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6440 DOBBIN RD STE D",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210454770",
            "telephone_number": "410-730-2385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "KRYSTAL",
        "middle_name": "MARYSA",
        "credential": "LGMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-27",
        "last_updated": "2023-11-27",
        "certification_date": "2023-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexandra M Cooper Bates
• Brittany Cooper
• Daniel Cooper
• Diana Cooper, RN
• Kiyah A Cooper
• Shanon Cooper
• Vicki Lynn Cooper, D.M.D.
• Susannah Lynn Coover, PT
• Coram Healthcare Corporation of Greater DC
• Natasha Corbin

• Marriage & Family Therapist in Columbia, MD
• Providers in Columbia, MD by specialty
• Marriage & Family Therapist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.