Individual provider Active NPI

Eva Anna Kool, LCSW-R

  • Mental Health Counselor
  • Ballston Lake, NY
National Provider Identifier
1396851796
Registry record updated Aug 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
R061422 Issued in NY
Practice address
315 Ushers Rd
Ballston Lake, NY 12019-1547
Phone
(518) 877-8812
Fax
(518) 877-8812
NPI assigned
Aug 21, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 2, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X R061422 NY Primary

Addresses

Primary practice location

315 Ushers Rd
Ballston Lake, NY 12019-1547

Mailing address

2 Cardinal CT
Clifton Park, NY 12065-2731
Phone (518) 877-8812

Other identifiers 1

IdentifierTypeStateIssuer
02134807MedicaidNY

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
R061422NYMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785628800000",
    "number": "1396851796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 CARDINAL CT",
            "city": "CLIFTON PARK",
            "state": "NY",
            "postal_code": "120652731",
            "telephone_number": "518-877-8812",
            "fax_number": "518-877-8812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 USHERS RD",
            "city": "BALLSTON LAKE",
            "state": "NY",
            "postal_code": "120191547",
            "telephone_number": "518-877-8812",
            "fax_number": "518-877-8812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOOL",
        "first_name": "EVA",
        "middle_name": "ANNA",
        "name_prefix": "Mrs.",
        "credential": "LCSW-R",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-21",
        "last_updated": "2026-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "R061422",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02134807",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ballston Lake, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2026; 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.