Cooperative Therapy LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

2007031620 Issued in MO

Legal business name

COOPERATIVE THERAPY LLC

Practice address

412 S Clay Ave
Lower Level
Kirkwood, MO 63122-5860

Phone

(314) 914-5762

NPI assigned

Nov 3, 2016

Organization subpart

No

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

Authorized official

Name

Jack Jacobsen, MSW, LCSWNPI 1679751291

Title

Owner

Phone

(314) 914-5762

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jack Jacobsen, MSW, LCSW

  • Clinical Social Worker
  • Webster Groves, MO
  • NPI 1679751291
  NPD (past) Authorized official

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

{
    "created_epoch": "1478131200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1478131200000",
    "number": "1780136945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "412 S CLAY AVE",
            "address_2": "LOWER LEVEL",
            "city": "KIRKWOOD",
            "state": "MO",
            "postal_code": "631225860",
            "telephone_number": "314-914-5762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "412 S CLAY AVE",
            "address_2": "LOWER LEVEL",
            "city": "KIRKWOOD",
            "state": "MO",
            "postal_code": "631225860",
            "telephone_number": "314-914-5762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COOPERATIVE THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-03",
        "last_updated": "2016-11-03",
        "status": "A",
        "authorized_official_last_name": "JACOBSEN",
        "authorized_official_first_name": "JACK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "314-914-5762",
        "authorized_official_credential": "MSW, LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2007031620",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cynthia June Coffman, CCC-SLP
• Janet L Collier, O.D.
• Cara Conde, MA, LPC
• Steven R Connelly, DMD
• Nancy Rumsey Cooksey, BSN, RN
• Jacquelynn Cornell, P.T.
• Corning Home Health Care LLC
• Karin Cowsert
• Adam David Cox, M.D.
• Craig J. Plahn DDS PC

• Clinical Social Worker in Kirkwood, MO
• Providers in Kirkwood, MO by specialty
• Clinical Social Worker in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2016; 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.