Jalen Cooper, LCSW, SAC-IT

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Practice address

1610 Miller Park Way
Milwaukee, WI 53214-3604

Phone

(414) 310-1248

Fax

(414) 672-6026

NPI assigned

Mar 25, 2022

Last updated

Jun 7, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1648166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717718400000",
    "number": "1821748542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4001 W CAPITOL DR",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532162530",
            "telephone_number": "414-455-3879",
            "fax_number": "866-719-3024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1610 MILLER PARK WAY",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532143604",
            "telephone_number": "414-310-1248",
            "fax_number": "414-672-6026"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4001 W Capitol Dr",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532162530",
            "country_code": "US",
            "telephone_number": "414-455-3879 x801",
            "fax_number": "866-719-3024",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COOPER",
        "first_name": "JALEN",
        "credential": "LCSW, SAC-IT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-03-25",
        "last_updated": "2024-06-07",
        "certification_date": "2024-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "1965-130",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniha J Cooper-Mays
• Chandra Cooper
• Daphanie Cooper
• Diana L Cooper, RN
• Hollie Cooper, REGISTERED NURSE
• Kasey Marie Cooper
• Kendall Scott Cooper, MD
• Matthew Cooper, M.D.
• Patrica Chris Ann Cooper, R.N
• Regina Cooper

• Clinical Social Worker in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Clinical Social Worker in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2024; 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.