Individual provider Active NPI

Susan L. Cook, M.A., MFT

  • Marriage & Family Therapist
  • Roseville, CA
National Provider Identifier
1871707869
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFC 32401 Issued in CA
Practice address
1891 E Roseville Pkwy
Suite 100
Roseville, CA 95661-7974
Phone
(916) 789-7082
Fax
(916) 797-8840
NPI assigned
May 9, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X MFC 32401 CA Primary

Addresses

Primary practice location

1891 E Roseville Pkwy
Suite 100
Roseville, CA 95661-7974

Mailing address

1891 East Roseville Parkway
Suite 100
Roseville, CA 95661-7974
Phone (916) 789-7082

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Feb 6, 2024 through Feb 6, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
MFC 32401CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Travis H Owens Psy D Inc PastSince Jul 29, 2009 Accepting new patients
Kenneth L. Larson, PH.D., Inc. PastSince Feb 1, 2020 Accepting new patients

Organizations & group practices 2

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": "1178668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1871707869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1891 EAST ROSEVILLE PARKWAY",
            "address_2": "SUITE 100",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956617974",
            "telephone_number": "916-789-7082",
            "fax_number": "916-797-8840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1891 E ROSEVILLE PKWY",
            "address_2": "SUITE 100",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956617974",
            "telephone_number": "916-789-7082",
            "fax_number": "916-797-8840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOK",
        "first_name": "SUSAN",
        "middle_name": "L.",
        "credential": "M.A., MFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC 32401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, CA

Sources for this page

Verify at the official NPI Registry.