Individual provider Active NPI

Teisha Marie Cook, LCSW

  • Clinical Social Worker
  • Wampsville, NY
National Provider Identifier
1447443437
Registry record updated Aug 22, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
074776 Issued in NY
Practice address
138 North Court Street
Wampsville, NY 13163-0608
Phone
(315) 366-2327
NPI assigned
Aug 22, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 074776 NY Primary

Addresses

Primary practice location

138 North Court Street
Wampsville, NY 13163-0608

Mailing address

PO Box 608
Veteran's Memorial Building
Wampsville, NY 13163-0608
Phone (315) 366-2327

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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

Enrollment IDStateProvider typePAC IDDetails
I20071205000459 NY Practitioner - Clinical Social Worker 4981793429 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
074776NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Madison County CurrentSince Dec 17, 2009 Accepting new patients

Locations

138 N Court St
#B
Wampsville, NY 13163

138 N Court St
Wampsville, NY 13163
Phone (315) 366-2788

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1187740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187740800000",
    "number": "1447443437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 608",
            "address_2": "VETERAN'S MEMORIAL BUILDING",
            "city": "WAMPSVILLE",
            "state": "NY",
            "postal_code": "131630608",
            "telephone_number": "315-366-2327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "138 NORTH COURT STREET",
            "city": "WAMPSVILLE",
            "state": "NY",
            "postal_code": "131630608",
            "telephone_number": "315-366-2327"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOK",
        "first_name": "TEISHA",
        "middle_name": "MARIE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-22",
        "last_updated": "2007-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "074776",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wampsville, NY

Sources for this page

Verify at the official NPI Registry.