Individual provider Active NPI

Cindy Cook, DSW. LCSW

  • Clinical Social Worker
  • Shorewood, IL
National Provider Identifier
1629663711
Registry record updated Mar 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.010301 Issued in IL
Practice address
21315 S Timber TRL
Shorewood, IL 60404-8242
Phone
(815) 690-2447
NPI assigned
Mar 1, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2021

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 149.010301 IL Primary

Addresses

Primary practice location

21315 S Timber TRL
Shorewood, IL 60404-8242

Mailing address

21315 S Timber TRL
Shorewood, IL 60404-8242
Phone (815) 690-2447

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

State licenses

LicenseStateTypeSpecialty
149.010301ILMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1614556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614556800000",
    "number": "1629663711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21315 S TIMBER TRL",
            "city": "SHOREWOOD",
            "state": "IL",
            "postal_code": "604048242",
            "telephone_number": "815-690-2447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21315 S TIMBER TRL",
            "city": "SHOREWOOD",
            "state": "IL",
            "postal_code": "604048242",
            "telephone_number": "815-690-2447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOK",
        "first_name": "CINDY",
        "name_prefix": "Dr.",
        "credential": "DSW. LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-01",
        "last_updated": "2021-03-01",
        "certification_date": "2021-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.010301",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shorewood, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2021; 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.