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KENYETTA LOVELEE COOPER LSCW, LCAS, CCS
NPI 1124687058
Social Worker - Clinical in Fayetteville, NC

Active since June 13, 2019PECOS Enrolled
5416 RAEFORD RD STE A, FAYETTEVILLE, NC 28304(704) 777-8858 Get Directions Write a Review

NPPES record last updated: October 17, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Aug 30, 2019, Jun 13, 2019 (2 updates tracked since 2019).

About Kenyetta Lovelee Cooper Lscw, Lcas, Ccs NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KENYETTA LOVELEE COOPER LSCW, LCAS, CCS (NPI 1124687058) is an individual clinical provider in Fayetteville, North Carolina, licensed in North Carolina (C013964) and active in the NPI registry since June 2019. She is enrolled in Medicare PECOS and is a graduate of Other (2019).

NPPES Registry Identity

NPI1124687058
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameKENYETTA LOVELEE COOPERCredential: LSCW, LCAS, CCS
Location Address5416 RAEFORD RD STE AFayetteville, NC 28304-3157
Mailing Address5416 Raeford Rd Ste AFayetteville, NC 28304-3157 · (704) 939-1100
Phone(704) 777-8858
Sole ProprietorNo
Medical School CMSOtherGraduated 2019
Enumeration DateJune 13, 2019
Last NPPES UpdateOctober 17, 20252 updates tracked since enumeration
NPPES CertifiedOctober 17, 2025
✔ NPI 1124687058 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
Licenses✔ Licensed in NC · C013964✔ Licensed in NC · CCS-21827
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
Also ListedCounselor · Addiction (Substance Use Disorder)Taxonomy 101YA0400X · License LCAS-25591 (NC)
5416 RAEFORD RD STE A, Fayetteville, NC 28304
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of NC, Harvard Pilgrim Health Care and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kenyetta Lovelee Cooper Lscw, Lcas, Ccs is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID5991183006
PECOS Enrollment IDI20250916001562, I20250923001820
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 28304 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$0.00 typical visit price
range $54.12 – $165.09
Typical copayment $0.00 (range $13.53 – $41.27)
Most-billed visit code NA
Established Patient
$67.72 typical visit price
range $17.21 – $134.61
Typical copayment $16.93 (range $4.30 – $33.65)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

FREE2BU THERAPEUTIC SERVICES PLLC
Community/Behavioral Health
5416 RAEFORD RD STE A
FAYETTEVILLE, NC 28304
Cumberland County (910) 760-1153
EXCEL TUTORING AND PERSONAL DEVELOPMENT
Community/Behavioral Health
5416 RAEFORD RD STE A
FAYETTEVILLE, NC 28304
Cumberland County (910) 223-7775

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kenyetta Cooper's NPI number?

The NPI number for Kenyetta Cooper is 1124687058. It was assigned to this individual provider in the NPPES registry on June 13, 2019.

Where is Kenyetta Cooper located?

Kenyetta Cooper practices at 5416 Raeford Rd Ste A, Fayetteville, NC 28304. The listed phone number is (704) 777-8858.

What is Kenyetta Cooper's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Kenyetta Cooper enrolled in Medicare?

Yes. Kenyetta Cooper is registered in the Medicare PECOS enrollment system.

What insurance does Kenyetta Cooper accept?

Health plans from Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of NC, Harvard Pilgrim Health Care, Oscar Health Plan of North Carolina, Inc and Oscar Insurance Company and 1 other insurer list Kenyetta Cooper as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Kenyetta Cooper was last updated on October 17, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.