Active NPI
Tara L Cook, LCSW
- Clinical Social Worker
- Champaign, IL
National Provider Identifier
1760616080
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- L4704
- Practice address
- 44 E Main St
Suite 406
Champaign, IL 61820-3636 - Phone
- (217) 398-9066
- Fax
- (217) 398-9077
- NPI assigned
- May 14, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | L4704 | OR | Primary |
Addresses
Primary practice location
44 E Main St
Suite 406
Champaign, IL 61820-3636
Mailing address
44 E Main St
Suite 406
Champaign, IL 61820-3636
Phone (217) 398-9066
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| L4704 | OR | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1242259200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1760486400000",
"number": "1760616080",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "44 E MAIN ST",
"address_2": "SUITE 406",
"city": "CHAMPAIGN",
"state": "IL",
"postal_code": "618203636",
"telephone_number": "217-398-9066",
"fax_number": "217-398-9077"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "44 E MAIN ST",
"address_2": "SUITE 406",
"city": "CHAMPAIGN",
"state": "IL",
"postal_code": "618203636",
"telephone_number": "217-398-9066",
"fax_number": "217-398-9077"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COOK",
"first_name": "TARA",
"middle_name": "L",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-05-14",
"last_updated": "2025-10-15",
"certification_date": "2025-10-15",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "OR",
"license": "L4704",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Champaign, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.