Diana L Cooke, MS
Individual provider Active NPI Marriage & Family Therapist · Jewett City, CT
NPI 1487908240 · NPPES record last updated Feb 23, 2021
Key facts
- NPI
- 1487908240
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Marriage & Family Therapist 106H00000X
- License
- 002526 (CT)
- Practice address
- 39 1/2 Wedgewood Dr Ste 1023
Jewett City, CT 06351-2439 - Phone
- (860) 497-0024
- NPI assigned
- Nov 1, 2012
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Marriage and Family Therapist
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
39 /2 Wedgewood Dr
Suite 1023
Jewett City, CT 06351-2439
Phone (860) 497-0024
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CT
- 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 |
|---|---|---|---|---|
| I20250512002000 | CT | Practitioner - Marriage and Family Therapist | 2264959386 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 185 | NH | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northeast Couple and Family Therapy | Marriage & Family Therapist | Current |
Accepting new patients |
| Community Council of Nashua NH, Inc. | Past |
Accepting new patients |
Locations
39 Wedgewood Dr
Ste 1023
Jewett City, CT 06351
Phone (860) 497-0024
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 185 | NH | |
| Mental Health Counselor | 101YM0800X | |||
| Marriage & Family Therapist | 106H00000X | 002526 | CT | Yes |
Addresses
Primary practice location
39 1/2 Wedgewood Dr Ste 1023
Jewett City, CT 06351-2439
Mailing address
39 1/2 Wedgewood Dr Ste 1023
Jewett City, CT 06351-2439
Phone (401) 290-7216
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | dcavaliere@counselingsecure.com | Health Information Exchange (HIE) |
Other providers in Jewett City, CT
- Amazing Home Care & Co
- American Legion Community Ambulance Inc
- Kayla Morgan Difrancesca
- Elite Management Services
- Elliott Counseling LLC
- Ewc 2, LLC
- Marissa Fratoni
All providers in Jewett City, CT · Marriage & Family Therapist in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 23, 2021. 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.