Active NPI
Kimberly Lattice Cook, M.ED., LPC
- Professional Counselor
- Tupelo, MS
National Provider Identifier
1619316254
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 2156
- Practice address
- 2434 S Eason Blvd
Tupelo, MS 38804-6942 - Phone
- (662) 844-1717
- Fax
- (662) 680-6416
- NPI assigned
- Jun 17, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Professional Counselor | 101YP2500X | 2156 | MS | Primary |
Addresses
Primary practice location
2434 S Eason Blvd
Tupelo, MS 38804-6942
Mailing address
2434 S Eason Blvd
Tupelo, MS 38804-6942
Phone (662) 844-1717
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Education
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2156 | MS | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1371427200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1494979200000",
"number": "1619316254",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2434 S EASON BLVD",
"city": "TUPELO",
"state": "MS",
"postal_code": "388046942",
"telephone_number": "662-844-1717",
"fax_number": "662-680-6416"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2434 S EASON BLVD",
"city": "TUPELO",
"state": "MS",
"postal_code": "388046942",
"telephone_number": "662-844-1717",
"fax_number": "662-680-6416"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COOK",
"first_name": "KIMBERLY",
"middle_name": "LATTICE",
"name_prefix": "Ms.",
"credential": "M.ED., LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-06-17",
"last_updated": "2017-05-17",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MS",
"license": "2156",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tupelo, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.