Active NPI
Christine Ann Cook, LCSW
- Clinical Social Worker
- Reston, VA
National Provider Identifier
1013078484
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 0904005822
- Practice address
- 11701 Bowman Green Dr
Reston, VA 20190 - Phone
- (703) 434-0255
- Fax
- (703) 644-1383
- NPI assigned
- Dec 12, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 0904005822 | VA | Primary |
Addresses
Primary practice location
11701 Bowman Green Dr
Reston, VA 20190
Mailing address
7113 Tanworth Dr
Springfield, VA 22152
Phone (703) 434-0255
Other identifiers 9
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 172232 | Other | ANTHEM | |
| 351226 | Other | VA | MHN |
| 2237372 | Other | CIGNA | |
| K449 | Other | CARE FIRST | |
| 250725 | Other | KAISER | |
| 351226 | Other | TRICARE | |
| 2131708 | Other | MAMSI | |
| 699685 | Other | NCPPO | |
| 9360114 | Other | PHCS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0904005822 | VA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165881600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1013078484",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7113 TANWORTH DR",
"city": "SPRINGFIELD",
"state": "VA",
"postal_code": "22152",
"telephone_number": "703-434-0255",
"fax_number": "703-644-1383"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11701 BOWMAN GREEN DR",
"city": "RESTON",
"state": "VA",
"postal_code": "20190",
"telephone_number": "703-434-0255",
"fax_number": "703-644-1383"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COOK",
"first_name": "CHRISTINE",
"middle_name": "ANN",
"name_prefix": "Ms.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-12",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "VA",
"license": "0904005822",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "172232",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MHN",
"identifier": "351226",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "2237372",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CARE FIRST",
"identifier": "K449",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "KAISER",
"identifier": "250725",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE",
"identifier": "351226",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAMSI",
"identifier": "2131708",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NCPPO",
"identifier": "699685",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHCS",
"identifier": "9360114",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Reston, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.