Daryl Ray Cooper, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

L411 Issued in OR

Practice address

2330 Marina Dr
Klamath Falls, OR 97601

Phone

(541) 883-3471

Fax

(541) 883-3524

NPI assigned

Apr 16, 2007

Last updated

Nov 16, 2016By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Lutheran Community Services Northwest

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Klamath Falls, OR
  • NPI 1720105489
  NPD (past)
• Lutheran Community Services NW

  • Counseling Psychologist
  • Klamath Falls, OR
  • NPI 1396862074
  NPD (past)

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

{
    "created_epoch": "1176681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479254400000",
    "number": "1962627844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2330 MARINA DRIVE",
            "city": "KLAMATH FALLS",
            "state": "OR",
            "postal_code": "97601",
            "telephone_number": "541-891-4402",
            "fax_number": "541-883-3524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2330 MARINA DR",
            "city": "KLAMATH FALLS",
            "state": "OR",
            "postal_code": "97601",
            "telephone_number": "541-883-3471",
            "fax_number": "541-883-3524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "DARYL",
        "middle_name": "RAY",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-16",
        "last_updated": "2016-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L411",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "090450",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER #",
            "identifier": "026825000",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael Connolly
• Ryan Matthew Conrady
• Conscious Connections Youth Counseling LLC
• Carolynn Elaine Conti, IBCLC, RN
• Amber Jean Cooley
• Gregory Cooper
• Jackie Lou Cooper, CADC 1
• John W Cooper, A.A.S., L.D.
• Kenzie Lynn Cooper
• Laurie Rae Cooper

• Clinical Social Worker in Klamath Falls, OR
• Providers in Klamath Falls, OR by specialty
• Clinical Social Worker in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2016; 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.