Michael David Cooke, LCSW-R

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

079001 Issued in NY

Practice address

1062 State Route 38
Owego, NY 13827

Phone

(607) 687-4000

Fax

(607) 687-6396

NPI assigned

Jan 24, 2007

Last updated

Dec 31, 2013By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in NY

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

Specialty

Clinical Social Worker

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Tioga CountyGroup PAC ID 6709786916, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Tioga County

  dba Tioga County Department of Mental Hygiene

  • Clinical Social Worker
  • Owego, NY
  • NPI 1124099700
  Medicare reassignment Care Compare group NPD
• Tioga County Health Department

  • Public Health or Welfare Agency
  • Owego, NY
  • NPI 1114078268
  NPD

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1388448000000",
    "number": "1285789180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1062 STATE ROUTE 38",
            "address_2": "PO BOX 177",
            "city": "OWEGO",
            "state": "NY",
            "postal_code": "138273209",
            "telephone_number": "607-687-4000",
            "fax_number": "607-687-6396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1062 STATE ROUTE 38",
            "city": "OWEGO",
            "state": "NY",
            "postal_code": "13827",
            "telephone_number": "607-687-4000",
            "fax_number": "607-687-6396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOKE",
        "first_name": "MICHAEL",
        "middle_name": "DAVID",
        "credential": "LCSW-R",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-24",
        "last_updated": "2013-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NY",
            "license": "17573",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "067008-1",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "079001",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00618162",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CASAC CREDENTIAL NUMBER",
            "identifier": "17573",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LCSW LICENSE NUMBER",
            "identifier": "079001",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LMSW LICENSE NUMBER",
            "identifier": "067008-1",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ashley Marie Coney
• Donald R Conning Jr.
• Nicholas Conti
• Lisa Marie Cook, OTR/L
• Matthew Kelley Cook, DDS
• Randolph B Cooke, MD
• Amy Coy
• Nicole Rae Crawford, LCSW
• Kathryn Maria Curatolo, RN, CLC
• CVS Albany LLC (CVS Pharmacy #02252)

• Clinical Social Worker in Owego, NY
• Providers in Owego, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2013; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.