Andrena Caroline Cooley, CSAC-I, NCCPSS

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

CADC-25884 Issued in NC

Practice address

3420 Wrightsville Ave
Wilmington, NC 28403-4118

Phone

(910) 725-3081

NPI assigned

Mar 26, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1585180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585180800000",
    "number": "1659908853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "708 HARPER AVE",
            "city": "CAROLINA BEACH",
            "state": "NC",
            "postal_code": "284284315",
            "telephone_number": "910-352-8750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3420 WRIGHTSVILLE AVE",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284034118",
            "telephone_number": "910-725-3081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOLEY",
        "first_name": "ANDRENA",
        "middle_name": "CAROLINE",
        "credential": "CSAC-I, NCCPSS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-26",
        "last_updated": "2020-03-26",
        "certification_date": "2020-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "CADC-25884",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "carolinec@pavillon.org",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "direct email",
            "address_1": "3420 Wrightsville Ave",
            "city": "Wilmington",
            "state": "NC",
            "country_code": "US",
            "postal_code": "284034118",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Mariah Cook
• Nathan Paul Cook, DO
• Phyllis Byers Cook, DDS, MPH, PA
• Rachel Olivia Cook, MSW, LCSW
• Tina Marie Cooke, LPC, LCADC, LCMHC
• William Purifoy Cooner, D.P.T.
• Brian Craig Cooper, LCCSWA
• Britainey Cooper, MA, ED.S, NCSP
• Dawson Michelle Cooper, MS
• Jessica Ann Cooper, LMBT

• Addiction (Substance Use Disorder) Counselor in Wilmington, NC
• Providers in Wilmington, NC by specialty
• Addiction (Substance Use Disorder) Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2020; 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.