Individual provider Active NPI

Brenda B Wine-Cooks, LMSW

  • Social Worker
  • Valley Stream, NY
National Provider Identifier
1174358006
Registry record updated Sep 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
03862 Issued in NY
Practice address
497 Rockaway Ave
Valley Stream, NY 11581-1909
Phone
(718) 845-2621
NPI assigned
Sep 2, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 03862 NY Primary

Addresses

Primary practice location

497 Rockaway Ave
Valley Stream, NY 11581-1909

Mailing address

3462 Third Ave Apt 9a
Bronx, NY 10456-4468
Phone (646) 319-5425

Other practice location 1

770 E 176th St
Bronx, NY 10460-4617
Phone (718) 583-5150

Other practice location 2

3462 Third Ave Apt 9A
Bronx, NY 10456-4468
Phone (646) 319-5425

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
03862NYMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1725235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725235200000",
    "number": "1174358006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3462 THIRD AVE APT 9A",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104564468",
            "telephone_number": "646-319-5425",
            "fax_number": "669-200-1010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "497 ROCKAWAY AVE",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115811909",
            "telephone_number": "718-845-2621"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "770 E 176th St",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104604617",
            "country_code": "US",
            "telephone_number": "718-583-5150",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3462 Third Ave Apt 9A",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104564468",
            "country_code": "US",
            "telephone_number": "646-319-5425",
            "fax_number": "669-200-1010",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WINE-COOKS",
        "first_name": "BRENDA",
        "middle_name": "B",
        "name_prefix": "Mrs.",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-09-02",
        "last_updated": "2024-09-02",
        "certification_date": "2024-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "03862",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valley Stream, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.