Jason Eugene Cook

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

540 Greenhaven Rd Ste 204
Anoka, MN 55303-1675

Phone

(763) 203-3164

Fax

(651) 925-0524

NPI assigned

Jun 12, 2015

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Nov 18, 2025 through Nov 18, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Greenhaven Therapy, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Anoka, MN
  • NPI 1699239194
  NPD (past) Authorized official
• Beacon Therapy Associates, PC

  • Marriage & Family Therapist
  • Champlin, MN
  • NPI 1407084031
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1434067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548720000000",
    "number": "1013398239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "540 GREENHAVEN RD STE 204",
            "city": "ANOKA",
            "state": "MN",
            "postal_code": "553031675",
            "telephone_number": "637-203-3164",
            "fax_number": "519-250-5246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 GREENHAVEN RD STE 204",
            "city": "ANOKA",
            "state": "MN",
            "postal_code": "553031675",
            "telephone_number": "763-203-3164",
            "fax_number": "651-925-0524"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11141 Zealand Ave N",
            "address_purpose": "LOCATION",
            "city": "Champlin",
            "state": "MN",
            "postal_code": "553163595",
            "country_code": "US",
            "telephone_number": "763-951-3091",
            "fax_number": "763-951-3097",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COOK",
        "first_name": "JASON",
        "middle_name": "EUGENE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-06-12",
        "last_updated": "2019-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brittany Clonch
• Stacie Cobb, CMT
• Bailey Colbert
• Tyrel Collins
• Community Addiction Recovery Enterprise Anoka
• Dylan Krash Cooper
• Cor Counseling Services LLC
• County of Anoka
• County of Anoka
• Claire Cox, OCCUPATIONAL THERAPI

• All providers in Anoka, MN
• Mental Health Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.