Elizabeth Cooley, B.A.

Primary specialty

Assisted Living Facility (Mental Illness)Taxonomy code 3104A0625X

License

AS380011354 Issued in MI

Practice address

2245 W Parnall Rd
Jackson, MI 49201-9000

Phone

(517) 787-9887

NPI assigned

Feb 29, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Elizabeth Cannon Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor of Arts

State licenses

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

{
    "created_epoch": "1709164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709164800000",
    "number": "1841057585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2245 W PARNALL RD",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492019000",
            "telephone_number": "517-787-9887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2245 W PARNALL RD",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492019000",
            "telephone_number": "517-787-9887"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1540 Steamburg Rd",
            "address_purpose": "LOCATION",
            "city": "Hillsdale",
            "state": "MI",
            "postal_code": "492422001",
            "country_code": "US",
            "telephone_number": "517-439-1490",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3475 Balmars Ave",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "MI",
            "postal_code": "492018618",
            "country_code": "US",
            "telephone_number": "517-782-2122",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1725 Bunting Rd",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "MI",
            "postal_code": "492017911",
            "country_code": "US",
            "telephone_number": "517-962-4360",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1600 Munith Rd",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "MI",
            "postal_code": "492018826",
            "country_code": "US",
            "telephone_number": "517-764-6040",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6708 Range Rd",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "MI",
            "postal_code": "492019530",
            "country_code": "US",
            "telephone_number": "517-569-4025",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "262 S Dettman Rd",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "MI",
            "postal_code": "492032205",
            "country_code": "US",
            "telephone_number": "517-962-4242",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COOLEY",
        "first_name": "ELIZABETH",
        "credential": "B.A.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-02-29",
        "last_updated": "2024-02-29",
        "certification_date": "2024-02-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3104A0625X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Mental Illness",
            "state": "MI",
            "license": "AS380011354",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "CANNON",
            "credential": "B.A.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Assisted Living Facility (Mental Illness) in Jackson, MI
• Providers in Jackson, MI by specialty
• Assisted Living Facility (Mental Illness) in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 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.