Vickie Cooke

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

LCA3165 Issued in MD

Practice address

3806 Ravenwood Ave
Baltimore, MD 21213-2022

Phone

(443) 629-0646

NPI assigned

Jan 28, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MD

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

Mental Health Counselor

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Healthy Minds LLCGroup PAC ID 5193199198, 4 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 and National Provider Directory roles.

• Healthy Minds LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Rosedale, MD
  • NPI 1437885795
  Medicare reassignment Care Compare group NPD
• Holistic Wellness Services

  • Adult Mental Health Clinic/Center
  • Baltimore, MD
  • NPI 1609587120

  Addiction (Substance Use Disorder)

  NPD Authorized official
• American Psychiatric Group, P.a.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Baltimore, MD
  • NPI 1043555733
  NPD (past)
• American Psychiatric Group, P.a.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Baltimore, MD
  • NPI 1720558828
  NPD (past)

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

{
    "created_epoch": "1453939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672963200000",
    "number": "1306203880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3394",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212130394",
            "telephone_number": "443-629-0646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3806 RAVENWOOD AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212132022",
            "telephone_number": "443-629-0646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOKE",
        "first_name": "VICKIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-01-28",
        "last_updated": "2023-01-06",
        "certification_date": "2023-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "MD",
            "license": "SC1812",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MD",
            "license": "LCA3165",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPARTMENT OF HEALTH AND MENTAL HYGIENE",
            "identifier": "SC1812",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer Anne Cooke, M.AC., L.AC.
• Joetta Cooke
• Kenneth Robert Cooke, MD
• Robyn Ciurca Cooke, C.R.N.A.
• Sarah Lancos Cooke, MSN, CRNA
• Juan C Cooks, PA-C
• Matthew Ryan Cookus
• Alicia Ann Cool, MD
• Michael D Cooley, C.R.N.P.
• Shon B Cooley, NP

• Addiction (Substance Use Disorder) Counselor in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Addiction (Substance Use Disorder) Counselor in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2023; 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.