Active NPI
Jennifer M Cooney, MS, CC, RBT, CBT
- Counselor
- Castle Rock, WA
National Provider Identifier
1073087052
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- CL61207828
- Practice address
- 498 Leckler Creek Rd
Castle Rock, WA 98611-9264 - Phone
- (360) 430-1594
- NPI assigned
- Jan 14, 2019
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | CL61207828 | WA | Primary |
| Behavior Technician | 106S00000X |
Addresses
Primary practice location
498 Leckler Creek Rd
Castle Rock, WA 98611-9264
Mailing address
498 Leckler Creek Rd
Castle Rock, WA 98611-9264
Phone (360) 430-1594
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
| License | State | Type | Specialty |
|---|---|---|---|
| CL61207828 | WA | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1547424000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1633910400000",
"number": "1073087052",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "498 LECKLER CREEK RD",
"city": "CASTLE ROCK",
"state": "WA",
"postal_code": "986119264",
"telephone_number": "360-430-1594"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "498 LECKLER CREEK RD",
"city": "CASTLE ROCK",
"state": "WA",
"postal_code": "986119264",
"telephone_number": "360-430-1594"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COONEY",
"first_name": "JENNIFER",
"middle_name": "M",
"credential": "MS, CC, RBT, CBT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-01-14",
"last_updated": "2021-10-11",
"certification_date": "2021-10-11",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "WA",
"license": "CL61207828",
"primary": true
},
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Castle Rock, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.