Individual provider Active NPI

Mimi Ann Cogswell, MS, LPC

  • Mental Health Counselor
  • Oregon City, OR
National Provider Identifier
1063494482
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
C1561 Issued in OR
Practice address
714B Main St
Suite 201
Oregon City, OR 97045-1821
Phone
(503) 740-5742
Fax
(503) 722-3964
NPI assigned
Nov 20, 2005
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X C1561 OR Primary

Addresses

Primary practice location

714B Main St
Suite 201
Oregon City, OR 97045-1821

Mailing address

17520 Holly LN
Oregon City, OR 97045-8523
Phone (503) 740-5742

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)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
C1561ORMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1132444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063494482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17520 HOLLY LN",
            "city": "OREGON CITY",
            "state": "OR",
            "postal_code": "970458523",
            "telephone_number": "503-740-5742",
            "fax_number": "503-722-3964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "714B MAIN ST",
            "address_2": "SUITE 201",
            "city": "OREGON CITY",
            "state": "OR",
            "postal_code": "970451821",
            "telephone_number": "503-740-5742",
            "fax_number": "503-722-3964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COGSWELL",
        "first_name": "MIMI",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "MS, LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-11-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "C1561",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oregon City, OR

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.

Verify at the official NPI Registry.