Individual provider Active NPI

Kaycee Kathleen McMullin Cook, LCSW

  • Clinical Social Worker
  • Cheyenne, WY
National Provider Identifier
1578037164
Registry record updated Jul 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904016558 Issued in VA
Practice address
401 W 19TH St Ste 305
Cheyenne, WY 82001-4358
Phone
(307) 222-2166
NPI assigned
Jan 16, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 15, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 0904016558 VA Primary

Addresses

Primary practice location

401 W 19TH St Ste 305
Cheyenne, WY 82001-4358

Mailing address

10908 Courthouse Rd Ste102
#241
Fredericksburg, VA 22408-8604
Phone (307) 640-5476

Other practice location 1

10315 Winter Park Ln
Spotsylvania, VA 22553-4490
Phone (307) 640-5476

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240612001562 WY Practitioner - Clinical Social Worker 6002358587 Practice locations: Cheyenne, WY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

401 W 19TH St
Suite 301
Cheyenne, WY 82001-4358
Phone (307) 222-2166

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW-1648WYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1547596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784073600000",
    "number": "1578037164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10908 COURTHOUSE RD STE102",
            "address_2": "#241",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224088604",
            "telephone_number": "307-640-5476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 W 19TH ST STE 305",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820014358",
            "telephone_number": "307-222-2166"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10315 Winter Park Ln",
            "address_purpose": "LOCATION",
            "city": "Spotsylvania",
            "state": "VA",
            "postal_code": "225534490",
            "country_code": "US",
            "telephone_number": "307-640-5476",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCMULLIN COOK",
        "first_name": "KAYCEE",
        "middle_name": "KATHLEEN",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-01-16",
        "last_updated": "2026-07-15",
        "certification_date": "2026-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904016558",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cheyenne, WY

Sources for this page

Verify at the official NPI Registry.