Kenyetta Cooper, LSCW, LCAS, CCS
NPI 1124687058 · Clinical Social Worker · Fayetteville, NC
Enrolled with Medicare as Practitioner - Clinical Social Worker · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Kenyetta Cooper, LSCW, LCAS, CCS is a Clinical Social Worker provider in Fayetteville, NC (NPI 1124687058).
Provider details
- NPI number
- 1124687058
- Entity type
- Individual
- Primary specialty
- Clinical Social WorkerBehavioral Health & Social Service Providers
- Credential
- LSCW, LCAS, CCS
- Sex
- Female
- Sole proprietor
- No
- License
- C013964 (NC)
Specialties & taxonomies
Behavioral Health & Social Service Providers
Behavioral Health & Social Service Providers
Behavioral Health & Social Service Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
7 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
2 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Additional practice locations (1)
- 1618 Bonforte Blvd Ste BPueblo, CO 81001-1676Phone: (704) 777-8858
Registry dates
- Enumerated
- 2019-06-13
- Last updated
- 2025-10-17
- Certified
- 2025-10-17
Frequently asked questions
- What is Kenyetta Cooper's NPI number?
- Kenyetta Cooper's National Provider Identifier (NPI) is 1124687058, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Kenyetta Cooper's specialty?
- Kenyetta Cooper is listed in the NPPES registry with a primary specialty of Clinical Social Worker (Behavioral Health & Social Service Providers).
- Where is Kenyetta Cooper located?
- Kenyetta Cooper's practice location on file with NPPES is 5416 Raeford Rd Ste a, Fayetteville, NC 28304-3157.
- What is Kenyetta Cooper's phone number?
- The practice phone number listed in the NPPES registry for Kenyetta Cooper is (704) 777-8858.
- Does Kenyetta Cooper accept Medicare?
- Kenyetta Cooper is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Kenyetta Cooper's NPI active?
- Yes — Kenyetta Cooper's NPI (1124687058) is active in the NPPES registry as of the last update on 2025-10-17.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.