Brendan Cooney

Key facts

NPI

1104605039

Entity type

Individual (NPI type 1)

Primary specialty

Mental Health Counselor 101YM0800X

License

MC61456318 (WA)

Practice address

530 Bogachiel Way
Forks, WA 98331-9120

Phone

(360) 374-5011

NPI assigned

Sep 28, 2023

Sex

Male

Sole proprietor

No

Organizations & group practices 2

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

• Clallam County Public Hospital District No 1 Critical Access Hospital · Forks, WA · NPI 1891879680
  Medicare reassignment NPD WA
• Clallam County Public Hospital District No 1 Rural Health Clinic/Center · Forks, WA · NPI 1285290338
  NPD

Medicare Care Compare profile

Specialty

Mental Health Counselor

Education

Other, 2023

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare participation

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

State licenses

Practice roles

Locations

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Sep 28, 2023.

{
    "created_epoch": "1695859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695859200000",
    "number": "1104605039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 BOGACHIEL WAY",
            "city": "FORKS",
            "state": "WA",
            "postal_code": "983319120",
            "telephone_number": "360-374-5011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 BOGACHIEL WAY",
            "city": "FORKS",
            "state": "WA",
            "postal_code": "983319120",
            "telephone_number": "360-374-5011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COONEY",
        "first_name": "BRENDAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-09-28",
        "last_updated": "2023-09-28",
        "certification_date": "2023-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "MC61456318",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forks, WA

• Clallam County Public Hospital District No 1
• Cathy A. Clark L.M.P., LIC. MASSAGE PRACTIT
• Concerned Citizens
• Kellie Linn Connery, P.T.
• Kyle Connery, DPT
• Richard Lee Dickson, MD
• Family Medical Center of Forks, Inc, PS
• Family Planning of Clallam County
• Felicia Mueller PLLC
• Ernest Ray Field II, MD

All providers in Forks, WA · Mental Health Counselor in Washington