Individual provider Active NPI

Rachelle Cooksey, LISW, LICDC

  • Clinical Social Worker
  • Circleville, OH
National Provider Identifier
1215533476
Registry record updated Dec 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I.1700330 Issued in OH
Practice address
18316 Ringgold Southern Rd
Circleville, OH 43113-9252
Phone
(330) 814-7589
NPI assigned
Dec 11, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 11, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1041C0700X I.1700330 OH Primary

Addresses

Primary practice location

18316 Ringgold Southern Rd
Circleville, OH 43113-9252

Mailing address

18316 Ringgold Southern Rd
Circleville, OH 43113-9252
Phone (330) 814-7589

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
I.1700330OHMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1607644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607644800000",
    "number": "1215533476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18316 RINGGOLD SOUTHERN RD",
            "city": "CIRCLEVILLE",
            "state": "OH",
            "postal_code": "431139252",
            "telephone_number": "330-814-7589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18316 RINGGOLD SOUTHERN RD",
            "city": "CIRCLEVILLE",
            "state": "OH",
            "postal_code": "431139252",
            "telephone_number": "330-814-7589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOKSEY",
        "first_name": "RACHELLE",
        "credential": "LISW, LICDC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-12-11",
        "last_updated": "2020-12-11",
        "certification_date": "2020-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.1700330",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Circleville, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2020; 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.