Jerry Alan Cooke, LISW LADC

Primary specialty

Social WorkerTaxonomy code 104100000X

License

I0879 Issued in NM

Practice address

234 Avenida Eldorado
Santa Fe, NM 87508-2221

Phone

(505) 466-6710

Fax

(505) 466-6710

NPI assigned

Nov 22, 2006

Last updated

May 7, 2026By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NM

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 1981

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1164153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778112000000",
    "number": "1033284229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "234 AVENIDA ELDORADO",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875082221",
            "telephone_number": "505-466-6710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "234 AVENIDA ELDORADO",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875082221",
            "telephone_number": "505-466-6710",
            "fax_number": "505-466-6710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOKE",
        "first_name": "JERRY",
        "middle_name": "ALAN",
        "name_prefix": "Mr.",
        "credential": "LISW LADC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-22",
        "last_updated": "2026-05-07",
        "certification_date": "2026-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OK",
            "license": "348",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NM",
            "license": "I0879",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q6658",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Devin Coogan
• Deanna Cook
• Deborah Smick Cook, MS PT
• Richard Myles Cook, PA
• Jeffrey Cooke, PT
• Iona Cooper, LPCC
• Susan Cooper, LCSW
• Elizabeth Cop
• Melanie Copeland, LCSW
• Copper Cloud Psychotherapy, LLC

• Social Worker in Santa Fe, NM
• Providers in Santa Fe, NM by specialty
• Social Worker in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.