Individual provider Active NPI

Tara Cook, LPC-MHSP

  • Counselor
  • Sparta, TN
National Provider Identifier
1619586138
Registry record updated Dec 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
5055 Issued in TN
Practice address
164 Churchill Dr
Sparta, TN 38583-1525
Phone
(931) 246-9449
Fax
(931) 256-8130
NPI assigned
Jul 30, 2020
Last updated
Dec 4, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 5055 TN Primary
Mental Health Counselor 101YM0800X 5055 TN

Addresses

Primary practice location

164 Churchill Dr
Sparta, TN 38583-1525

Mailing address

164 Churchill Dr
Sparta, TN 38583-1525
Phone (931) 485-5995

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20240108004681 TN Practitioner - Mental Health Counselor 9537510102 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5055TNMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Insightful Pediatric and Family Therapy, LLC CurrentSince Jan 1, 2024 Accepting new patients

Locations

150 N Willow Ave
Cookeville, TN 38501
Phone (931) 246-9449

164 Churchill Dr
Sparta, TN 38583
Phone (931) 246-9449

410 N Spring St
Sparta, TN 38583
Phone (931) 246-9449

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1596067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733270400000",
    "number": "1619586138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "164 CHURCHILL DR",
            "city": "SPARTA",
            "state": "TN",
            "postal_code": "385831525",
            "telephone_number": "931-485-5995",
            "fax_number": "931-256-8130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "164 CHURCHILL DR",
            "city": "SPARTA",
            "state": "TN",
            "postal_code": "385831525",
            "telephone_number": "931-246-9449",
            "fax_number": "931-256-8130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOK",
        "first_name": "TARA",
        "credential": "LPC-MHSP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-30",
        "last_updated": "2024-12-04",
        "certification_date": "2024-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "TN",
            "license": "5055",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TN",
            "license": "5055",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sparta, TN

Sources for this page

Verify at the official NPI Registry.