Individual provider Active NPI

Christine Thomas Cossio, LCSW

  • Clinical Social Worker
  • Hurlburt Field, FL
National Provider Identifier
1063181162
Registry record updated Apr 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
23764 Issued in FL
Practice address
1 Somdg-SGHQ
113 Lielmanis Ave.
Hurlburt Field, FL 32544
Phone
(850) 428-6374
NPI assigned
Sep 10, 2021
Last updated
Apr 16, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 16, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 65213 TX
Clinical Social Worker 1041C0700X 23764 FL Primary

Addresses

Primary practice location

1 Somdg-SGHQ
113 Lielmanis Ave.
Hurlburt Field, FL 32544

Mailing address

1 Somdg-SGHQ
113 Lielmanis Ave.
Hurlburt Fieldd, FL 32544
Phone (850) 428-6374

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
23764FLMDClinical Social Worker
65213TXMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1631232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744761600000",
    "number": "1063181162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 SOMDG-SGHQ",
            "address_2": "113 LIELMANIS AVE.",
            "city": "HURLBURT FIELDD",
            "state": "FL",
            "postal_code": "32544",
            "telephone_number": "850-428-6374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 SOMDG-SGHQ",
            "address_2": "113 LIELMANIS AVE.",
            "city": "HURLBURT FIELD",
            "state": "FL",
            "postal_code": "32544",
            "telephone_number": "850-428-6374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSSIO",
        "first_name": "CHRISTINE",
        "middle_name": "THOMAS",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-10",
        "last_updated": "2025-04-16",
        "certification_date": "2025-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "65213",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "23764",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hurlburt Field, FL

Sources for this page

Verify at the official NPI Registry.