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JILL COOPER LLC
Complete NPI Record 1649008376
Social Worker - Clinical in Concord, NH

NPI Status: Active since July 24, 2024

Contact Information

19 CYPRESS ST
CONCORD, NH
ZIP 03301
Phone: (603) 219-6400

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Table of Contents

  1. NPI
  2. Entity Type Code
  3. Employer Identification Number EIN
  4. Provider Organization Name Legal Business Name
  5. Provider First Line Business Mailing Address
  6. Provider Business Mailing Address City Name
  7. Provider Business Mailing Address State Name
  8. Provider Business Mailing Address Postal Code
  9. Provider Business Mailing Address Country Code If outside U S
  10. Provider First Line Business Practice Location Address
  11. Provider Business Practice Location Address City Name
  12. Provider Business Practice Location Address State Name
  13. Provider Business Practice Location Address Postal Code
  14. Provider Business Practice Location Address Country Code If outside U S
  15. Provider Business Practice Location Address Telephone Number
  16. Provider Enumeration Date
  17. Last Update Date
  18. Authorized Official Last Name
  19. Authorized Official First Name
  20. Authorized Official Title or Position
  21. Authorized Official Telephone Number
  22. Healthcare Provider Taxonomy Code 1
  23. Healthcare Provider Primary Taxonomy Switch 1
  24. Is Organization Subpart
  25. Authorized Official Credential Text
  26. Healthcare Provider Taxonomy Group 1
  27. NPI Certification Date

Complete NPI Dataset

This page represents the complete record for NPI 1649008376. You can access the complete dataset, including a full list of field names, along with their values, and definitions as recorded by the NPI registry. Each field in the NPI record is explained, highlighting its significance and the possible values it can hold.

NPI: 1649008376
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address State name’’.
Entity Type Code: 2
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as ‘‘Provider location address postal code’’.
Employer Identification Number EIN: UNAVAIL
The Employer Identification Number (EIN), assigned by the IRS, of the provider being identified.
The name of the organization provider. If the provider is an organization, this is the legal business name.
Provider First Line Business Mailing Address: 19 CYPRESS ST
The first line mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider first line location address’’.
Provider Business Mailing Address City Name: CONCORD
The city name in the mailing address of the provider being identified.
Provider Business Mailing Address State Name: NH
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address State name’’.
Provider Business Mailing Address Postal Code: 033012315
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as ‘‘Provider location address postal code’’.
Provider Business Mailing Address Country Code If outside U S : US
The country code in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address country code’’.
Provider First Line Business Practice Location Address: 19 CYPRESS ST
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City Name: CONCORD
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State Name: NH
The State code in the location of the provider being identified.
Provider Business Practice Location Address Postal Code: 033012315
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Country Code If outside U S : US
The country code in the location address of the provider being identified.
Provider Business Practice Location Address Telephone Number: 6032196400
The telephone number associated with the location address of the provider being identified.
Provider Enumeration Date: 7/24/2024
The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date: 8/1/2024
The date that a record was last updated or changed.
Authorized Official Last Name: COOPER
The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
Authorized Official First Name: JILL
The first name of the authorized official.
Authorized Official Title or Position: LLC MEMBER
The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
Authorized Official Telephone Number: 6032196400
Healthcare Provider Taxonomy Code 1: 1041C0700X
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Healthcare Provider Primary Taxonomy Switch 1: Y
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Is Organization Subpart: N
Authorized Official Credential Text: MSW
Healthcare Provider Taxonomy Group 1: 193200000X MULTI-SPECIALTY GROUP
NPI Certification Date: 8/1/2024