Healthcare Provider Details

I. General information

NPI: 1023992252
Provider Name (Legal Business Name): JAMES COOLEY MSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2025
Last Update Date: 08/19/2025
Certification Date: 08/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

735 MCMILLAN ROAD
CLEMSON SC
29634-0001
US

IV. Provider business mailing address

BOX 344054
CLEMSON SC
29634-0001
US

V. Phone/Fax

Practice location:
  • Phone: 864-656-2451
  • Fax:
Mailing address:
  • Phone: 864-656-2451
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number16012
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: