Sharon Flora Cooke, LISW
Individual provider Active NPI Clinical Social Worker · Bloomfield, NM
NPI 1962611228 · NPPES record last updated Jul 9, 2007
Key facts
- NPI
- 1962611228
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- I-3996 (NM)
- Practice address
- 310 W Sycamore Ave
Bloomfield, NM 87413-5844 - Phone
- (505) 634-3628
- Fax
- (505) 634-3675
- NPI assigned
- May 22, 2007
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| I-3996 | NM | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | I-3996 | NM | Yes |
Addresses
Primary practice location
310 W Sycamore Ave
Bloomfield, NM 87413-5844
Mailing address
8475 Foothills Dr
Farmington, NM 87402-0977
Phone (505) 634-3628
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000Z0886 | Medicaid | NM |
Other providers in Bloomfield, NM
- Michelle Childers-Beck
- Terre G Coberly
- Kristi Coddington
- Victoria D. Coe
- Cynthia Colson
- Brandon Ira Crockett
- Telecia Crockett
- Anna Marie Curtis
- Kellen Dean
- Karen Dennis
All providers in Bloomfield, NM · Clinical Social Worker in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 9, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.