Mandi Danielle Cooke, LCSW, LCAS

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Practice address

4730 Woodsway LN
Farmville, NC 27828-8513

Phone

(252) 315-0676

NPI assigned

Jan 3, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Mandi Danielle Cauley Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1578009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703548800000",
    "number": "1144869421",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4730 WOODSWAY LN",
            "city": "FARMVILLE",
            "state": "NC",
            "postal_code": "278288513",
            "telephone_number": "252-315-0676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4730 WOODSWAY LN",
            "city": "FARMVILLE",
            "state": "NC",
            "postal_code": "278288513",
            "telephone_number": "252-315-0676"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "806 Hay St",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "NC",
            "postal_code": "283055312",
            "country_code": "US",
            "telephone_number": "910-860-7008",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "719 Wood Point Dr",
            "address_purpose": "LOCATION",
            "city": "Bunnlevel",
            "state": "NC",
            "postal_code": "283237501",
            "country_code": "US",
            "telephone_number": "252-315-0676",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COOKE",
        "first_name": "MANDI",
        "middle_name": "DANIELLE",
        "credential": "LCSW, LCAS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-01-03",
        "last_updated": "2023-12-26",
        "certification_date": "2023-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MANDI",
            "last_name": "CAULEY",
            "middle_name": "DANIELLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Clinical Social Worker in Farmville, NC
• Providers in Farmville, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.