Active NPI
Robert F Cook, PSY.D.
- Clinical Psychologist
- Carbondale, IL
National Provider Identifier
1912692591
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 071.010209
- Practice address
- 604 Eastgate St
Carbondale, IL 62901-3304 - Phone
- (618) 203-4790
- Fax
- (618) 305-8449
- NPI assigned
- Apr 10, 2023
- Sex
- Male
- Sole proprietor
- Yes
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 Psychologist | 103TC0700X | 071.010209 | IL | Primary |
Addresses
Primary practice location
604 Eastgate St
Carbondale, IL 62901-3304
Mailing address
PO Box 791
Carbondale, IL 62903-0791
Phone (618) 203-4790
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1681084800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1712361600000",
"number": "1912692591",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 791",
"city": "CARBONDALE",
"state": "IL",
"postal_code": "629030791",
"telephone_number": "618-203-4790",
"fax_number": "618-305-8449"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "604 EASTGATE ST",
"city": "CARBONDALE",
"state": "IL",
"postal_code": "629013304",
"telephone_number": "618-203-4790",
"fax_number": "618-305-8449"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COOK",
"first_name": "ROBERT",
"middle_name": "F",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-04-10",
"last_updated": "2024-04-06",
"certification_date": "2024-04-06",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "IL",
"license": "071.010209",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Carbondale, IL
- Community Health & Emergency Services, Inc
- Community Health & Emergency Services, Inc.
- Complete Family Eyecare of Carbondale, PC
- Cook Psychological Services, LLC
- Lynn Scott Cook, MD
- Kathy A Cooper, LCSW
- Scott A. Cooper, M.D.
- Holly Cormier, PH.D.
- Kristine Laubhan Cornett, P.T.
- Alejandra Q Corona, LSW
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.