Individual provider Active NPI

Kelsi Cook

  • Psychologist
  • Spokane, WA
National Provider Identifier
1073906699
Registry record updated Jun 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PY61358035 Issued in WA
Practice address
105 W 8TH Ave Ste 418C
Spokane, WA 99204-2318
Phone
(509) 474-6920
NPI assigned
Mar 5, 2015
Last updated
Jun 30, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X
Psychologist 103T00000X PY61358035 WA Primary
Behavior Analyst 103K00000X 10-3K00000X WA

Addresses

Primary practice location

105 W 8TH Ave Ste 418C
Spokane, WA 99204-2318

Mailing address

PO Box 421
Liberty Lake, WA 99019-0421
Phone (866) 747-2455

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT, WA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230601001960 UT Practitioner - Clinical Psychologist 8921465279 Reassigns benefits to 1 organization
I20230706001346 WA Practitioner - Clinical Psychologist 8921465279 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

105 W 8TH Ave
Suite 418C
Spokane, WA 99204-2318
Phone (509) 474-6920

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
10-3K00000XWAMDBehavioral Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Washington CurrentSince Jul 30, 2023 Accepting new patients
Valley Mental Health Incorporated Current Accepting new patients
Valley Behavioral Health Incorporated CurrentSince Apr 17, 2023 Accepting new patients

Locations

4460 S Highland Dr
Slc, UT 84124
Phone (801) 263-7101

4460 S Highland Dr
Ste 230
Slc, UT 84124
Phone (801) 263-7227

1200 E Columbia Ave
Colville, WA 99114
Phone (509) 684-3701

105 W 8th Ave
Ste 418C
Spokane, WA 99204
Phone (509) 474-1960

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1425513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688083200000",
    "number": "1073906699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 421",
            "city": "LIBERTY LAKE",
            "state": "WA",
            "postal_code": "990190421",
            "telephone_number": "866-747-2455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 W 8TH AVE STE 418C",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992042318",
            "telephone_number": "509-474-6920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOK",
        "first_name": "KELSI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-05",
        "last_updated": "2023-06-30",
        "certification_date": "2023-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WA",
            "license": "PY61358035",
            "primary": true
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "WA",
            "license": "10-3K00000X",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

Verify at the official NPI Registry.