Active NPI
Jawara Dia Cooley, MED, LPC, NCC
- Mental Health Counselor
- Laurel, MD
National Provider Identifier
1659965325
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- PRC200001661
- Practice address
- 14625 Baltimore Ave # 801
Laurel, MD 20707-4902 - Phone
- (202) 734-6820
- NPI assigned
- Feb 23, 2021
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LGPC00826 | DC | |
| Mental Health Counselor | 101YM0800X | PRC200001661 | DC | Primary |
Addresses
Primary practice location
14625 Baltimore Ave # 801
Laurel, MD 20707-4902
Mailing address
14625 Baltimore Ave # 801
Laurel, MD 20707-4902
Phone (202) 734-6820
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 2001
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2100 Washington Blvd
Arlington, VA 22204-5717
Phone (703) 228-1611
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Education
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PRC200001661 | DC | MD | Mental Health Counselor |
| LGPC00826 | DC | MD | Professional Counselor |
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 and National Provider Directory roles.
-
- Community/Behavioral Health Agency
- Arlington, VA
- NPI 1043280415
DC
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1614038400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1673913600000",
"number": "1659965325",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14625 BALTIMORE AVE # 801",
"city": "LAUREL",
"state": "MD",
"postal_code": "207074902",
"telephone_number": "202-734-6820"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14625 BALTIMORE AVE # 801",
"city": "LAUREL",
"state": "MD",
"postal_code": "207074902",
"telephone_number": "202-734-6820"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COOLEY",
"first_name": "JAWARA",
"middle_name": "DIA",
"credential": "MED, LPC, NCC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-02-23",
"last_updated": "2023-01-17",
"certification_date": "2023-01-17",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "DC",
"license": "LGPC00826",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "DC",
"license": "PRC200001661",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Laurel, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.