Candace Cooper, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LCPC-8147 Issued in ID

Practice address

3350 W Americana Ter Ste 210B
Boise, ID 83706-2521

Phone

(208) 316-9381

NPI assigned

Jun 25, 2019

Last updated

Apr 3, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Active Pursuit Therapy LLC

  dba Active Pursuit Therapy

  • Professional Counselor
  • Boise, ID
  • NPI 1154072023
  NPD Authorized official

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

{
    "created_epoch": "1561420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648944000000",
    "number": "1962063487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10416 W PETEARANA ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837041251",
            "telephone_number": "208-316-9381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3350 W AMERICANA TER STE 210B",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837062521",
            "telephone_number": "208-316-9381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "CANDACE",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-25",
        "last_updated": "2022-04-03",
        "certification_date": "2022-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "ID",
            "license": "LCPC-8147",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joseph Alan Coones, RN
• Vanness Lynn Coonrod, SLP1695
• Kendra Coonse, M.D.
• Abigail Elizabeth Cooper, LPC
• Amy L. Cooper, MD
• Clive R Cooper, MD
• Hayden Cooper
• Jonah Cooper
• Lauren Marissa Cooper, MD
• Lynzi Cooper

• Professional Counselor in Boise, ID
• Providers in Boise, ID by specialty
• Professional Counselor in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2022; 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.