Michelle P Cooke, PSY.D, LADC I, CADC

Primary specialty

Addiction (Substance Use Disorder) PsychologistTaxonomy code 103TA0400X

License

1470 Issued in SC

Practice address

4390 Belle Oaks Dr
North Charleston, SC 29405

Phone

(843) 414-2670

NPI assigned

Aug 20, 2013

Last updated

Jul 21, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1376956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1497188999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1211 DINGLE RD",
            "city": "MOUNT PLEASANT",
            "state": "SC",
            "postal_code": "294669386",
            "telephone_number": "978-500-2776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4390 BELLE OAKS DR",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "29405",
            "telephone_number": "843-414-2670"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10 Mason Brook Ln",
            "address_purpose": "LOCATION",
            "city": "Littleton",
            "state": "MA",
            "postal_code": "014601530",
            "country_code": "US",
            "telephone_number": "617-903-8446",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COOKE",
        "first_name": "MICHELLE",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "PSY.D, LADC I, CADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-20",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TA0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": "MA",
            "license": "10590",
            "primary": false
        },
        {
            "code": "103TA0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": "SC",
            "license": "1470",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Ann Conrad, RN
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• Lin W. Cook, IBCLC,RLC,CLC,AAHCC
• Nancy Cook, LPC, CRC, LAC
• Brian Fletcher Cooke
• Cooper Cosmetic & Family Dentistry
• Amy Kathleen Cooper, DMD
• Shantana Cooper, PMHNP
• Coosaw Dental, LLC
• Coosaw Eye Center (Festival Eye Center)

• Addiction (Substance Use Disorder) Psychologist in North Charleston, SC
• Providers in North Charleston, SC by specialty
• Addiction (Substance Use Disorder) Psychologist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.