Individual provider Active NPI

Courtney Hale Cook, MA

  • Counselor
  • North Liberty, IA
National Provider Identifier
1659684363
Registry record updated Apr 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Practice address
1290 Jordan St
North Liberty, IA 52317-8020
Phone
(319) 356-6352
NPI assigned
Jul 22, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X Primary

Addresses

Primary practice location

1290 Jordan St
North Liberty, IA 52317-8020

Mailing address

1290 Jordan St
North Liberty, IA 52317-8020
Phone (319) 356-6352

Other practice location 1

2175 Lexington Blvd
Building #2
Washington, IA 52353-9108
Phone (319) 653-6161

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20231122000555 IA Practitioner - Mental Health Counselor 1759739279 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Psychiatric Associates of Iowa, PCGroup PAC ID 9638550544, 50 clinicians

Practice addresses (Care Compare)

1290 Jordan St
North Liberty, IA 52317-8020
Phone (319) 432-0531

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
001410IAMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Psychiatric Associates of Iowa, PC CurrentSince Jan 1, 2024 Accepting new patients
Psychiatric Associates of Iowa, PC CurrentSince Jan 1, 2024 Accepting new patients

Locations

3900 Fountains Blvd NE
Ste 203
Cedar Rapids, IA 52411
Phone (319) 727-8297

1290 Jordan St
North Liberty, IA 52317
Phone (319) 356-6352

1900 Silver Lake Rd NW
Ste 110
Saint Paul, MN 55112
Phone (651) 379-1718

1900 Silver Lake Rd NW
Saint Paul, MN 55112
Phone (651) 379-1704

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1279756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651276800000",
    "number": "1659684363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1290 JORDAN ST",
            "city": "NORTH LIBERTY",
            "state": "IA",
            "postal_code": "523178020",
            "telephone_number": "319-356-6352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1290 JORDAN ST",
            "city": "NORTH LIBERTY",
            "state": "IA",
            "postal_code": "523178020",
            "telephone_number": "319-356-6352"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2175 Lexington Blvd",
            "address_2": "Building #2",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "IA",
            "postal_code": "523539108",
            "country_code": "US",
            "telephone_number": "319-653-6161",
            "fax_number": "319-863-1311",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COOK",
        "first_name": "COURTNEY",
        "middle_name": "HALE",
        "name_prefix": "Mr.",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-22",
        "last_updated": "2022-04-30",
        "certification_date": "2022-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Liberty, IA

Sources for this page

Verify at the official NPI Registry.