Active NPI
John Allan Cook, LCSW
- Clinical Social Worker
- Wasilla, AK
National Provider Identifier
1699953158
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- CSWS381
- Practice address
- 1363 W Spruce Ave
Wasilla, AK 99654 - Phone
- (907) 376-2411
- Fax
- (907) 352-3363
- NPI assigned
- Feb 7, 2008
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | C005914 | NC | |
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | NC | ||
| Clinical Social Worker | 1041C0700X | CSWS381 | AK | Primary |
Addresses
Primary practice location
1363 W Spruce Ave
Wasilla, AK 99654
Mailing address
1363 W Spruce Ave
Wasilla, AK 99654
Phone (907) 376-2411
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 561949434 | Other | NC | BCBS |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C005914 | NC | MD | Mental Health Counselor |
| CSWS381 | AK | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lee S Hyde and Gail Hyde PTR | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1202342400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1489536000000",
"number": "1699953158",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1363 W SPRUCE AVE",
"city": "WASILLA",
"state": "AK",
"postal_code": "99654",
"telephone_number": "907-376-2411",
"fax_number": "907-352-3363"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1363 W SPRUCE AVE",
"city": "WASILLA",
"state": "AK",
"postal_code": "99654",
"telephone_number": "907-376-2411",
"fax_number": "907-352-3363"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COOK",
"first_name": "JOHN",
"middle_name": "ALLAN",
"name_prefix": "Mr.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-02-07",
"last_updated": "2017-03-15",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NC",
"license": "C005914",
"primary": false
},
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "NC",
"license": null,
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "AK",
"license": "CSWS381",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "561949434",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wasilla, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.