Active NPI
Susan Cooper, LCSW-C
- Clinical Social Worker
- Rockville, MD
National Provider Identifier
1962564690
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 04123
- Practice address
- 917 Willowleaf Way
Rockville, MD 20854-2946 - Phone
- (301) 294-7912
- Fax
- (301) 294-7913
- NPI assigned
- Dec 16, 2006
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 04123 | MD | Primary |
Addresses
Primary practice location
917 Willowleaf Way
Rockville, MD 20854-2946
Mailing address
917 Willowleaf Way
Rockville, MD 20854-2946
Phone (301) 294-7912
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8190 | Other | MD | CAREFIRST BLUECROSS |
| 11247749 | Other | MD | AETNA |
| 217388 | Other | MD | KAISER PERMANENTE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20081015000640 | DC | Practitioner - Clinical Social Worker | 8224196597 | Practice locations: Potomac, MD |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 1975
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
917 Willowleaf Way
Potomac, MD 20854-2946
Phone (301) 294-7912
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166227200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1962564690",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "917 WILLOWLEAF WAY",
"city": "ROCKVILLE",
"state": "MD",
"postal_code": "208542946",
"telephone_number": "301-294-7912",
"fax_number": "301-294-7913"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "917 WILLOWLEAF WAY",
"city": "ROCKVILLE",
"state": "MD",
"postal_code": "208542946",
"telephone_number": "301-294-7912",
"fax_number": "301-294-7913"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COOPER",
"first_name": "SUSAN",
"credential": "LCSW-C",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-12-16",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MD",
"license": "04123",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAREFIRST BLUECROSS",
"identifier": "8190",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "11247749",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "KAISER PERMANENTE",
"identifier": "217388",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Rockville, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.