Individual provider Active NPI

Alaine C Cooley, LSW

  • Clinical Social Worker
  • Dayton, OH
National Provider Identifier
1245637941
Registry record updated Nov 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I.1600263 Issued in OH
Practice address
601 S Edwin C Moses Blvd
Samaritan Behavioral Health, Inc.
Dayton, OH 45417-3424
Phone
(937) 734-8333
Fax
(937) 734-4343
NPI assigned
Nov 24, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X I.1600263 OH Primary

Addresses

Primary practice location

601 S Edwin C Moses Blvd
Samaritan Behavioral Health, Inc.
Dayton, OH 45417-3424

Mailing address

601 S Edwin C Moses Blvd FL 4
Samaritan Behavioral Health Inc.
Dayton, OH 45417-3424
Phone (937) 734-8333

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
I.1600263OHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Modern Psychiatry & Wellness, LLC CurrentSince Nov 1, 2020 Accepting new patients
Telehealth Counseling, LLC Clinical Current Accepting new patients

Locations

1910 Fairgrove Ave
Ste E
Hamilton, OH 45011
Phone (513) 299-4025

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/5507/brand/1/csg/1/fhir/r4

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.

NPI Registry JSON

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

{
    "created_epoch": "1416787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478476800000",
    "number": "1245637941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 S EDWIN C MOSES BLVD FL 4",
            "address_2": "SAMARITAN BEHAVIORAL HEALTH INC.",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454173424",
            "telephone_number": "937-734-8333",
            "fax_number": "937-734-4343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 S EDWIN C MOSES BLVD",
            "address_2": "SAMARITAN BEHAVIORAL HEALTH, INC.",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454173424",
            "telephone_number": "937-734-8333",
            "fax_number": "937-734-4343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOLEY",
        "first_name": "ALAINE",
        "middle_name": "C",
        "credential": "LSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-11-24",
        "last_updated": "2016-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.1600263",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2016; 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.