Active NPI
Daryl Cooley, M.S.
- Clinical Psychologist
- Little Rock, AR
National Provider Identifier
1902297252
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 202174
- Practice address
- 4301 W Markham St # 654
Little Rock, AR 72205-7101 - Phone
- (857) 264-0965
- NPI assigned
- Feb 9, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Clinical Psychologist | 103TC0700X | 202174 | AR | Primary |
Addresses
Primary practice location
4301 W Markham St # 654
Little Rock, AR 72205-7101
Mailing address
715 N 2ND St
Nashville, TN 37207-5905
Phone (508) 308-1623
Other practice location 1
1 Childrens Way # 654
Little Rock, AR 72202-3500
Phone (501) 364-1992
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1307576 | Medicaid | MA | |
| M18463 | Other | MA | BLUE CROSS BLUE SHIELD |
| 1303295 | Medicaid | MA |
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 202174 | AR | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1423440000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1654214400000",
"number": "1902297252",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "715 N 2ND ST",
"city": "NASHVILLE",
"state": "TN",
"postal_code": "372075905",
"telephone_number": "508-308-1623"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4301 W MARKHAM ST # 654",
"city": "LITTLE ROCK",
"state": "AR",
"postal_code": "722057101",
"telephone_number": "857-264-0965"
}
],
"practiceLocations": [
{
"address_1": "1 Childrens Way # 654",
"address_purpose": "LOCATION",
"city": "Little Rock",
"state": "AR",
"postal_code": "722023500",
"country_code": "US",
"telephone_number": "501-364-1992",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "COOLEY",
"first_name": "DARYL",
"credential": "M.S.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-02-09",
"last_updated": "2022-06-03",
"certification_date": "2022-06-03",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "AR",
"license": "202174",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1307576",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "M18463",
"state": "MA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1303295",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Little Rock, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.