Lacey Cook, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

2018033383 Issued in MO

Practice address

3105 Independence St Ste B
Cape Girardeau, MO 63703-5042

Phone

(573) 334-4477

Fax

(573) 334-0622

NPI assigned

Jan 31, 2020

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

Other names 1

• Lacey Duckworth Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1580428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580428800000",
    "number": "1568093219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 N 2ND ST STE 200",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633012894",
            "telephone_number": "636-224-1210",
            "fax_number": "636-946-0991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3105 INDEPENDENCE ST STE B",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637035042",
            "telephone_number": "573-334-4477",
            "fax_number": "573-334-0622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOK",
        "first_name": "LACEY",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-31",
        "last_updated": "2020-01-31",
        "certification_date": "2020-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "MO",
            "license": "2018033383",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MO DIVISION OF PROFESSIONAL REGISTRY",
            "identifier": "2018033383",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LACEY",
            "last_name": "DUCKWORTH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Conversation Connections LLC
• Jason A Conway, M.D.
• Austin Cook
• Christy L Cook, WHNP
• Kelsie Elizabeth Cook
• Martha J Cook, PHD, CCC-SLP
• Tracey D Cooley
• Don Curtis Coonce, MD
• James K Cooper II, DO
• Shaina L Cooper, FNP

• All providers in Cape Girardeau, MO
• Behavior Analyst in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2020; 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.