Active NPI
Christal June Cooper, LMSW
- Professional Counselor
- Nampa, ID
National Provider Identifier
1912485772
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LMSW-28189
- Practice address
- 823 Parkcentre Way
Nampa, ID 83651-1783 - Phone
- (208) 475-5065
- Fax
- (208) 463-0972
- NPI assigned
- Aug 3, 2018
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LMSW-28189 | ID | Primary |
Addresses
Primary practice location
823 Parkcentre Way
Nampa, ID 83651-1783
Mailing address
11510 W 1St St
Star, ID 83669-5267
Phone (208) 921-9931
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LMSW-28189 | ID | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1533254400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1533254400000",
"number": "1912485772",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11510 W 1ST ST",
"city": "STAR",
"state": "ID",
"postal_code": "836695267",
"telephone_number": "208-921-9931"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "823 PARKCENTRE WAY",
"city": "NAMPA",
"state": "ID",
"postal_code": "836511783",
"telephone_number": "208-475-5065",
"fax_number": "208-463-0972"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COOPER",
"first_name": "CHRISTAL",
"middle_name": "JUNE",
"credential": "LMSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-08-03",
"last_updated": "2018-08-03",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "ID",
"license": "LMSW-28189",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Nampa, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 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.