Mychal Cooper

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

11652-C Issued in NV

Practice address

4751 Best Rd Ste 400R
Atlanta, GA 30337-5609

Phone

(470) 775-3195

NPI assigned

Jul 31, 2012

Last updated

Nov 21, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Trademark Child and Family Services Inc

  • Clinical Social Worker
  • Atlanta, GA
  • NPI 1245865633
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1343692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732147200000",
    "number": "1881940559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "441 WALNUT CREEK DR",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302815878",
            "telephone_number": "270-312-5386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4751 BEST RD STE 400R",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303375609",
            "telephone_number": "470-775-3195"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4660 S Eastern Ave Ste 108A",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891196137",
            "country_code": "US",
            "telephone_number": "470-775-3195",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COOPER",
        "first_name": "MYCHAL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-31",
        "last_updated": "2024-11-21",
        "certification_date": "2024-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW006928",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NV",
            "license": "11652-C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lawrence Erwin Cooper, MD
• Lequiter Monet Cooper
• Lisa Cooper
• Malik Cooper, PTA
• Mary Alice Cooper, PA
• Nakia Cooper
• Nasya Cooper
• Neil B Cooper, MD
• Owen Cooper
• Robert Cooper, MD

• Clinical Social Worker in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Clinical Social Worker in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.