Angela D Kooken, LMSW
Individual provider Active NPI Social Worker · Salina, KS
NPI 1407168347 · NPPES record last updated Sep 13, 2010
Key facts
- NPI
- 1407168347
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- License
- 7783 (KS)
- Practice address
- 509 E Elm St
Salina, KS 67401-2353 - Phone
- (785) 825-0541
- Fax
- (785) 825-0062
- NPI assigned
- Jul 8, 2010
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Clinical Social Worker
- Education
- Other, 2010
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Iroquois Center for Human Development, Inc.
Practice addresses (Care Compare)
610 E Grant Ave
Greensburg, KS 67054-2708
Phone (620) 723-2272
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KS
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260129003063 | KS | Practitioner - Clinical Social Worker | 2264910405 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7783 | KS | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Iroquois Center for Human Development, Inc. | Current |
Accepting new patients | |
| Iroquois Center for Human Development, Inc. | Current |
Accepting new patients |
Locations
610 E Grant Ave
Greensburg, KS 67054
Phone (620) 723-2272
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 7783 | KS | Yes |
Addresses
Primary practice location
509 E Elm St
Salina, KS 67401-2353
Mailing address
509 E Elm St
Salina, KS 67401-2353
Phone (785) 825-0541
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200655340A | Medicaid | KS |
Other providers in Salina, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 13, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.