Phyllis T. Cook, CAC-AD, CCDC, ICADC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

AC0191 Issued in MD

Practice address

2823 Ocean Gtwy
Cambridge, MD 21613-3403

Phone

(410) 221-6343

Fax

(410) 221-6342

NPI assigned

Dec 5, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Choices Family Services, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Cambridge, MD
  • NPI 1427005941
  NPD (past)

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1487712907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8715 SHADOW LN",
            "city": "DELMAR",
            "state": "MD",
            "postal_code": "218752551",
            "telephone_number": "410-221-6343",
            "fax_number": "410-221-6342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2823 OCEAN GTWY",
            "city": "CAMBRIDGE",
            "state": "MD",
            "postal_code": "216133403",
            "telephone_number": "410-221-6343",
            "fax_number": "410-221-6342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOK",
        "first_name": "PHYLLIS",
        "middle_name": "T.",
        "name_prefix": "Mrs.",
        "credential": "CAC-AD, CCDC, ICADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MD",
            "license": "AC0191",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CERTIFIED ADDICTION COUNS",
            "identifier": "AC0191",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Community Behavioral Health, LLC
• Community Behavioral Health, LLC
• Community Behavioral Health, LLC
• Comptroller of Maryland Central Payroll Bureau
• David Conlon, PT
• Brittany Allison Cooper, LCSW-C
• Corsica River Mental Health Service, Inc.
• Corsica River Mental Health Service, Inc.
• Tiffani Cotton
• Sara Wozny Coulbourn, M.D.

• Addiction (Substance Use Disorder) Counselor in Cambridge, MD
• Providers in Cambridge, MD by specialty
• Addiction (Substance Use Disorder) Counselor in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.