Marty T. Cooke, LCPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LCPC3448 Issued in ID

Practice address

500 S 11TH Ave
Suite 302
Pocatello, ID 83201-4835

Phone

(208) 233-0150

Fax

(208) 233-0159

NPI assigned

Jan 4, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1831246594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4986",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832054986",
            "telephone_number": "208-233-0150",
            "fax_number": "208-233-0159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 S 11TH AVE",
            "address_2": "SUITE 302",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832014835",
            "telephone_number": "208-233-0150",
            "fax_number": "208-233-0159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOKE",
        "first_name": "MARTY",
        "middle_name": "T.",
        "credential": "LCPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "ID",
            "license": "LCPC3448",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Consumer Care LLC
• Chace Cook, MD
• Darryl Bruce Cook, M.D.
• Roger A Cook, MD
• Stephanie Cook, MT
• Kapra Jade Cooley-Rieders
• Natalie A Cooper, LAT, ATC
• Coordinated Care Services
• Heather Marie Corbet, MOTR/L
• Cathy Cordell

• Mental Health Counselor in Pocatello, ID
• Providers in Pocatello, ID by specialty
• Mental Health Counselor in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.