Active NPI
David Cooper, LCSW
- Social Worker
- Fort Wayne, IN
National Provider Identifier
1902862410
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 34000392
- Practice address
- 415 E Cook Rd
Ste 100
Fort Wayne, IN 46825-3636 - Phone
- (260) 489-6030
- NPI assigned
- Apr 24, 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 |
|---|---|---|---|---|
| Social Worker | 104100000X | 34000392 | IN | Primary |
Addresses
Primary practice location
415 E Cook Rd
Ste 100
Fort Wayne, IN 46825-3636
Mailing address
415 E Cook Rd
Ste 100
Fort Wayne, IN 46825-3636
Phone (260) 489-6030
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 |
|---|---|---|---|
| 34000392 | IN | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1145836800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1206662400000",
"number": "1902862410",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "415 E COOK RD",
"address_2": "STE 100",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468253636",
"telephone_number": "260-489-6030"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "415 E COOK RD",
"address_2": "STE 100",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468253636",
"telephone_number": "260-489-6030"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COOPER",
"first_name": "DAVID",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-24",
"last_updated": "2008-03-28",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "IN",
"license": "34000392",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Wayne, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.