Blake Cook

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

44SC05454100 Issued in NJ

Practice address

85 Crescent Ave
Passaic, NJ 07055-2437

Phone

(201) 421-7371

NPI assigned

Jul 6, 2020

Sex

Female

Sole proprietor

Yes

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

Enrolled in NJ

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Senior Care Therapy LLC

  • Clinical Psychologist
  • Passaic, NJ
  • NPI 1285898098
  Medicare reassignment NPD

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

{
    "created_epoch": "1593993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594166400000",
    "number": "1962020040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 SCHMITT RD",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070522227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 CRESCENT AVE",
            "city": "PASSAIC",
            "state": "NJ",
            "postal_code": "070552437",
            "telephone_number": "201-421-7371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOK",
        "first_name": "BLAKE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-07-06",
        "last_updated": "2020-07-08",
        "certification_date": "2020-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC05454100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Complete Care at Hamilton LLC
• Complete Neurological Care of NJ PC
• Confident Care Corp
• Connect ABA and Therapy Services LLC
• Constructive ABA Inc
• Walter Cosillo, LAC
• Alyssa Taylor Coughlin, BCBA
• CPL (Hamilton) LLC
• Joseph M. Crawley, MD
• Rosario D Cruz-Castillo, M.ED., LAC

• Clinical Social Worker in Passaic, NJ
• Providers in Passaic, NJ by specialty
• Clinical Social Worker in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2020; 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.