Individual provider Active NPI

Dustin James Cooley, MSW, LCSW

  • Clinical Social Worker
  • Columbia, MO
National Provider Identifier
1134425994
Registry record updated Aug 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2013025358 Issued in MO
Practice address
3401 Berrywood Dr
Columbia, MO 65201-8372
Phone
(573) 777-8330
NPI assigned
Jan 26, 2011
Last updated
Aug 12, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 2013025358 MO
Clinical Social Worker 1041C0700X 2013025358 MO Primary

Addresses

Primary practice location

3401 Berrywood Dr
Columbia, MO 65201-8372

Mailing address

1300 E Bradford Pkwy
Springfield, MO 65804-4264
Phone (417) 269-5400

Other identifiers 1

IdentifierTypeStateIssuer
494562002MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20150506000524 MO Practitioner - Clinical Social Worker 5890014237 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Burrell IncGroup PAC ID 4486548625, 217 clinicians

Practice addresses (Care Compare)

1300 E Bradford Pkwy
Springfield, MO 65804-4264

210 N Williams
Burrell Behavioral Health
Moberly, MO 65720-1583
Phone (660) 263-7651

2885 W Battlefield St
Springfield, MO 65807-3952
Phone (417) 761-5800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2013025358MOMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Burrell, Inc. CurrentSince Mar 21, 2015 Accepting new patients
Burrell, Inc. CurrentSince Mar 21, 2015 Accepting new patients

Locations

1805 E Walnut St
Columbia, MO 65201
Phone (573) 777-7500

3401 Berrywood Dr
Columbia, MO 65201
Phone (573) 777-7530

1300 E Bradford Pkwy
Springfield, MO 65804
Phone (417) 269-5400

1300 E Bradford Pkwy
#H
Springfield, MO 65804

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, 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": "1296000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754956800000",
    "number": "1134425994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 E BRADFORD PKWY",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658044264",
            "telephone_number": "417-269-5400",
            "fax_number": "417-269-7212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 BERRYWOOD DR",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652018372",
            "telephone_number": "573-777-8330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOLEY",
        "first_name": "DUSTIN",
        "middle_name": "JAMES",
        "credential": "MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-01-26",
        "last_updated": "2025-08-12",
        "certification_date": "2025-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MO",
            "license": "2013025358",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2013025358",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "494562002",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MO

Sources for this page

Verify at the official NPI Registry.