Individual provider Active NPI

Leslie Danielle Cook, LCSW

  • Clinical Social Worker
  • Silver City, NM
National Provider Identifier
1083744742
Registry record updated Jul 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C-09990 Issued in NM
Practice address
1318 E 32ND St
Silver City, NM 88061
Phone
(575) 388-4412
NPI assigned
Mar 6, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2018

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 C-09990 NM Primary
School Social Worker 1041S0200X B04834 NM

Addresses

Primary practice location

1318 E 32ND St
Silver City, NM 88061

Mailing address

530 De Moss St
Lordsburg, NM 88045-2618
Phone (575) 542-2369

Other names 1

  • Leslie Danielle Willis Former name

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20221217000287 NM Practitioner - Clinical Social Worker 0749538924 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C-09990NMMDClinical Social Worker
B04834NMMDSchool Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Journey to Wellness Counseling Los Lunas, LLC CurrentSince Nov 1, 2022 Accepting new patients

Locations

536 Los Lentes Rd SE
Ste A
Los Lunas, NM 87031
Phone (505) 944-6626

Organizations & group practices 1

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": "1173139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532390400000",
    "number": "1083744742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 DE MOSS ST",
            "city": "LORDSBURG",
            "state": "NM",
            "postal_code": "880452618",
            "telephone_number": "575-542-2369",
            "fax_number": "575-542-2388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1318 E 32ND ST",
            "city": "SILVER CITY",
            "state": "NM",
            "postal_code": "88061",
            "telephone_number": "575-388-4412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOK",
        "first_name": "LESLIE",
        "middle_name": "DANIELLE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-06",
        "last_updated": "2018-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NM",
            "license": "C-09990",
            "primary": true
        },
        {
            "code": "1041S0200X",
            "taxonomy_group": "",
            "desc": "Social Worker, School",
            "state": "NM",
            "license": "B04834",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LESLIE",
            "last_name": "WILLIS",
            "middle_name": "DANIELLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Silver City, NM

Sources for this page

Verify at the official NPI Registry.