Active NPI
Michael Harold Cooter, L.C.S.W.
- Clinical Social Worker
- Luke Afb, AZ
National Provider Identifier
1861581803
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCSW 11966
- Practice address
- 7219 N Litchfield Rd
Luke Afb, AZ 85309-1529 - Phone
- (623) 856-7579
- Fax
- (623) 856-4433
- NPI assigned
- Oct 11, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LCSW 11966 | AZ | Primary |
Addresses
Primary practice location
7219 N Litchfield Rd
Luke Afb, AZ 85309-1529
Mailing address
7219 N Litchfield Rd
Luke Afb, AZ 85309-1529
Phone (623) 856-7579
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| LCSW11966 | Other | AZ | LCSW |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCSW 11966 | AZ | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160524800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1861581803",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7219 N LITCHFIELD RD",
"city": "LUKE AFB",
"state": "AZ",
"postal_code": "853091529",
"telephone_number": "623-856-7579",
"fax_number": "623-856-4433"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7219 N LITCHFIELD RD",
"city": "LUKE AFB",
"state": "AZ",
"postal_code": "853091529",
"telephone_number": "623-856-7579",
"fax_number": "623-856-4433"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COOTER",
"first_name": "MICHAEL",
"middle_name": "HAROLD",
"credential": "L.C.S.W.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-11",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "AZ",
"license": "LCSW 11966",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LCSW",
"identifier": "LCSW11966",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Luke Afb, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.