Kelley L Cook, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

081035 Issued in NY

Practice address

127 W State St
Ithaca, NY 14850-5474

Phone

(607) 273-7494

Fax

(607) 273-7484

NPI assigned

Sep 19, 2007

Last updated

Apr 18, 2014By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Family and Children Services of Ithaca

  • Social Worker
  • Ithaca, NY
  • NPI 1306077425
  NPD (past)

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

{
    "created_epoch": "1190160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397779200000",
    "number": "1548456007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "127 W STATE ST",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148505474",
            "telephone_number": "607-273-7494",
            "fax_number": "607-273-7484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "127 W STATE ST",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148505474",
            "telephone_number": "607-273-7494",
            "fax_number": "607-273-7484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOK",
        "first_name": "KELLEY",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-09-19",
        "last_updated": "2014-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MA",
            "license": "216366",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "116486",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "081035",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erin Grace Connors, OTR/L
• Mary Katherine Conroy, OD
• Meredith Alison Conroy, MSPT
• Marcia J Conte, RPA
• Joanne C Conway Pietrasz, MFT
• Paige Marie Cook, LPN
• Phebe V Cook, RN
• Kristen Wayman Cooke, LMHC
• Emilee Cool, LMSW
• Daniel A. Cooper, LMHC

• Clinical Social Worker in Ithaca, NY
• Providers in Ithaca, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2014; 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.