Ricky Cooper Jr., LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

61395980 Issued in WA

Practice address

10005 24TH St E
Edgewood, WA 98371-2130

Phone

(253) 533-3248

NPI assigned

Jun 8, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Annie Malone Children and Family Service Center

  • Adolescent and Children Mental Health Clinic/Center
  • St. Louis, MO
  • NPI 1942449194
  NPD (past)
• Profectus Counseling, LLC

  • Mental Health Counselor
  • Clayton, MO
  • NPI 1043802077

  Mental Health

  NPD (past)

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

{
    "created_epoch": "1591574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679875200000",
    "number": "1801411673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7924 164TH ST E",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983757207",
            "telephone_number": "314-722-5843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10005 24TH ST E",
            "city": "EDGEWOOD",
            "state": "WA",
            "postal_code": "983712130",
            "telephone_number": "253-533-3248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "RICKY",
        "name_suffix": "Jr.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-08",
        "last_updated": "2023-03-27",
        "certification_date": "2023-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MO",
            "license": "2018043309",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "61395980",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peter Y Chien, D.M.D.
• Yuliya Chumachenko, RN
• Tammie Diane Clark, LPN
• Kyle Eugene Clyde, LMP
• Conti Chiropractic PLLC
• Alexandria Criss
• Desiree Vaughan Cutarelli, MSW
• Alyssa Rochelle Dale
• Ercia Devaux, LPN
• Edgewood Acupuncture

• Mental Health Counselor in Edgewood, WA
• Providers in Edgewood, WA by specialty
• Mental Health Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2023; 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.