Active NPI
Donna Cooke, M.A.
- Clinical Psychologist
- Chattaroy, WV
National Provider Identifier
1356488431
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 808
- Practice address
- 2954 Buffalo Creek Rd
Chattaroy, WV 25667 - Phone
- (304) 235-2954
- NPI assigned
- Jan 30, 2007
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 808 | WV | Primary |
Addresses
Primary practice location
2954 Buffalo Creek Rd
Chattaroy, WV 25667
Mailing address
PO Box 176
Logan, WV 25601-0176
Phone (304) 792-7130
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 808 | WV | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Logan-Mingo Area Mental Health, Inc | Past | Accepting new patients | |
| Logan-Mingo Area Mental Health, Inc | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Mountain Laurel Integrated Healthcare
- Federally Qualified Health Center (FQHC)
- Logan, WV
- NPI 1598396202
-
- Federally Qualified Health Center (FQHC)
- Chattaroy, WV
- NPI 1861023699
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170115200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1356488431",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 176",
"city": "LOGAN",
"state": "WV",
"postal_code": "256010176",
"telephone_number": "304-792-7130",
"fax_number": "304-792-7138"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2954 BUFFALO CREEK RD",
"city": "CHATTAROY",
"state": "WV",
"postal_code": "25667",
"telephone_number": "304-235-2954"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COOKE",
"first_name": "DONNA",
"name_prefix": "Ms.",
"credential": "M.A.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-30",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "WV",
"license": "808",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chattaroy, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.