Organization Active NPI

Cooper Psychological Services PC

  • Clinical Psychologist
  • Smyrna, GA
National Provider Identifier
1922212323
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
1460 Issued in GA
Legal business name
COOPER PSYCHOLOGICAL SERVICES PC
Practice address
3188 Atlandta Rd SE
Smyrna, GA 30080
Phone
(770) 435-7770
Fax
(770) 435-9440
NPI assigned
May 9, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. John T Cooper, PHD
Title
President Licensed Psychologist
Phone
(770) 435-7770

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X 1460 GA Primary

Addresses

Primary practice location

3188 Atlandta Rd SE
Smyrna, GA 30080

Mailing address

227 Sandy Springs Place
#D375
Sandy Springs, GA 30328-5918
Phone (770) 435-7770

Other identifiers 1

IdentifierTypeStateIssuer
00441548DMedicaidGA

Other names 1

  • John T Cooper PhD Other name

National Provider Directory

National Provider Directory

Locations

227 Sandy Springs Pl
#D375
Sandy Springs, GA 30328

NPI Registry JSON

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

{
    "created_epoch": "1178668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1922212323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "227 SANDY SPRINGS PLACE",
            "address_2": "#D375",
            "city": "SANDY SPRINGS",
            "state": "GA",
            "postal_code": "303285918",
            "telephone_number": "770-435-7770",
            "fax_number": "770-435-9440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3188 ATLANDTA RD SE",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "30080",
            "telephone_number": "770-435-7770",
            "fax_number": "770-435-9440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COOPER PSYCHOLOGICAL SERVICES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "COOPER",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PRESIDENT LICENSED PSYCHOLOGIST",
        "authorized_official_telephone_number": "770-435-7770",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "GA",
            "license": "1460",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00441548D",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "John T Cooper PhD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Smyrna, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.