Individual provider Active NPI

Suzanne Michele Mondell-Cook

  • Clinical Social Worker
  • San Diego, CA
National Provider Identifier
1477979755
Registry record updated Jun 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
77060 Issued in CA
Practice address
4455 Murphy Canyon Rd Ste 100
San Diego, CA 92123-4379
Phone
(619) 304-0637
NPI assigned
Mar 11, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 15, 2022

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 77060 CA Primary

Addresses

Primary practice location

4455 Murphy Canyon Rd Ste 100
San Diego, CA 92123-4379

Mailing address

9562 Winter Gardens Blvd # D-320
Lakeside, CA 92040-4065
Phone (619) 304-0637

Other practice location 1

1260 Morena Blvd Ste 100
San Diego, CA 92110-3850
Phone (619) 398-0355

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

State licenses

LicenseStateTypeSpecialty
77060CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Teladoc Health Medical Group, P.a. Mental Health Current Accepting new patients
Cappy'S House Counseling Services, LCSW Mental Health Current Accepting new patients

Locations

4455 Murphy Canyon Rd
Ste 100
San Diego, CA 92123
Phone (619) 281-6067

Interoperability endpoints

  • Direct secure messaging: suzannemondellcook@tdh.allscriptsdirect.net

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1394496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655251200000",
    "number": "1477979755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9562 WINTER GARDENS BLVD # D-320",
            "city": "LAKESIDE",
            "state": "CA",
            "postal_code": "920404065",
            "telephone_number": "619-304-0637",
            "fax_number": "619-326-3884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4455 MURPHY CANYON RD STE 100",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921234379",
            "telephone_number": "619-304-0637"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1260 Morena Blvd Ste 100",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921103850",
            "country_code": "US",
            "telephone_number": "619-398-0355",
            "fax_number": "619-398-0350",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MONDELL-COOK",
        "first_name": "SUZANNE",
        "middle_name": "MICHELE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-03-11",
        "last_updated": "2022-06-15",
        "certification_date": "2022-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "77060",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2022; 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.