Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mary Shevon Hackett Cooper

Individual provider Professional Counselor · NPI 1144857814

Mary Shevon Hackett Cooper is a Mental Health Counselor in Greensboro, North Carolina. Qualified in 2016, 10 years ago. Practices with Jodi Province Counseling Services PLLC, a 13-clinician group and accepts Medicare assignment. Licensed in North Carolina.

Years since qualifying
10
Licensed in
NC
In the registry since
2020
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Practice location Address checks out

510 Summit Ave
Greensboro, NC 27405-7740
Phone: (336) 333-6853
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Professional Counselor (primary) Taxonomy 101YP2500X · Licence A14868 (NC)

Record details

NPI number1144857814
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedMarch 24, 2020
Last updated in NPPESMarch 24, 2020
Certification dateMarch 24, 2020

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 2016 (10 years in practice)
Group practice Jodi Province Counseling Services Pllc — 13 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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