Damon Lavaughn Cooke, LCD SUD COUNSELOR

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

17146 Issued in CA

Practice address

6355 Gordon Valley Rd
Napa, CA 94558-8614

Phone

(707) 319-7145

Fax

(707) 703-5794

NPI assigned

Jun 22, 2024

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1719014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719446400000",
    "number": "1295579449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6355 GORDON VALLEY RD",
            "city": "NAPA",
            "state": "CA",
            "postal_code": "945588614",
            "telephone_number": "707-319-7145",
            "fax_number": "707-703-5794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6355 GORDON VALLEY RD",
            "city": "NAPA",
            "state": "CA",
            "postal_code": "945588614",
            "telephone_number": "707-319-7145",
            "fax_number": "707-703-5794"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "490 Chadbourne Rd Ste A108",
            "address_purpose": "LOCATION",
            "city": "Fairfield",
            "state": "CA",
            "postal_code": "945341823",
            "country_code": "US",
            "telephone_number": "707-530-5538",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COOKE",
        "first_name": "DAMON",
        "middle_name": "LAVAUGHN",
        "credential": "LCD SUD COUNSELOR",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-06-22",
        "last_updated": "2024-06-27",
        "certification_date": "2024-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "17146",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erica Sandra Conway, DDS
• Tiffany Marie Conway
• Annette Cook
• Nikki Cook
• Ty Cook
• Mary C. Cooke, D.D.S., M.S.
• Christine Anne Cookson
• Christian Cooley
• Jacqueline Coon
• Kristina Cooper, PTA

• Addiction (Substance Use Disorder) Counselor in Napa, CA
• Providers in Napa, CA by specialty
• Addiction (Substance Use Disorder) Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 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.