Matthew A Cooley, BS
Individual provider Active NPI Mental Health Counselor · Newton, IL
NPI 1669735593 · NPPES record last updated Jun 15, 2012
Key facts
- NPI
- 1669735593
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- Practice address
- 106 Edwards St
Newton, IL 62448-1736 - Phone
- (618) 783-4154
- Fax
- (618) 783-2339
- NPI assigned
- Jun 15, 2012
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Bachelor of Science
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Yes |
Addresses
Primary practice location
106 Edwards St
Newton, IL 62448-1736
Mailing address
106 Edwards St
Newton, IL 62448-1736
Phone (618) 783-4154
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 376001106007 | Medicaid | IL | |
| 376001106006 | Medicaid | IL |
Other providers in Newton, IL
- Champion Fitness, Inc
- Caitlin Chapman
- Kierstin Clark
- Haylee Ann Cohorst
- Charles T Coleman
- County of Jasper
- County of Jasper
- County of Jasper
- Crawford Hospital District
- Amy Deel-Hout
All providers in Newton, IL · Mental Health Counselor in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 15, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.