Individual provider Active NPI

Zachary Bowman Cooke, LMFT

  • Marriage & Family Therapist
  • Goshen, IN
National Provider Identifier
1487249819
Registry record updated Oct 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
35002323A Issued in IN
Practice address
117 S 5TH St
Goshen, IN 46528-3711
Phone
(574) 228-5189
NPI assigned
Mar 8, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 35002323A IN Primary

Addresses

Primary practice location

117 S 5TH St
Goshen, IN 46528-3711

Mailing address

117 S 5TH St
Goshen, IN 46528-3711
Phone (574) 228-5189

Other names 1

  • Zachary Alan Cooke Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Oct 9, 2024 through Oct 9, 2026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
35002323AINMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
ZBC Therapy LLC Counselor Current Accepting new patients

Locations

117 S 5th St
Goshen, IN 46528
Phone (574) 231-7010

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": "1615161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730246400000",
    "number": "1487249819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 S 5TH ST",
            "city": "GOSHEN",
            "state": "IN",
            "postal_code": "465283711",
            "telephone_number": "574-228-5189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 S 5TH ST",
            "city": "GOSHEN",
            "state": "IN",
            "postal_code": "465283711",
            "telephone_number": "574-228-5189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOKE",
        "first_name": "ZACHARY",
        "middle_name": "BOWMAN",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-08",
        "last_updated": "2024-10-30",
        "certification_date": "2024-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "IN",
            "license": "35002323A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ZACHARY",
            "last_name": "COOKE",
            "middle_name": "ALAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Goshen, IN

Sources for this page

Verify at the official NPI Registry.