Ethan McCooper, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

087070 Issued in NY

Practice address

280 Madison Ave RM 1011
New York, NY 10016

Phone

(646) 676-0138

Fax

(646) 844-6963

NPI assigned

Jun 22, 2015

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

Other identifiers 1

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": "1434931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531440000000",
    "number": "1851773329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 BERGEN ST APT 105",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112383586",
            "telephone_number": "646-676-0138",
            "fax_number": "718-398-8942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280 MADISON AVE RM 1011",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10016",
            "telephone_number": "646-676-0138",
            "fax_number": "646-844-6963"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "801 Bergen St Apt 105",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112383586",
            "country_code": "US",
            "telephone_number": "646-676-0138",
            "fax_number": "718-398-8942",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCCOOPER",
        "first_name": "ETHAN",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-06-22",
        "last_updated": "2018-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "094329-1",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "087070",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "83-1100806",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Danielle M McConville, LMSW
• Jacquelyn C. McConville, MD
• Justin Raymond McConville, ATC
• Thomas Howe McConville, M.D.
• Martha McCool
• Jamie Lynn McCoppin, LCAT, RDT
• Mary McCord, MD
• Sarah E. McCord, PA-C
• Peter Niles McCorkell, M.D.
• David McCorkle, LCSW

• Clinical Social Worker in New York, NY
• Providers in New York, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2018; 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.