Ivelisses Cooke, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

092959 Issued in NY

Practice address

743 Clifton St
Forked River, NJ 08731-1323

Phone

(609) 401-2566

NPI assigned

Oct 13, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Avena Psychological Services PLLC

  • Clinical Psychologist
  • New York, NY
  • NPI 1043896244

  Single Specialty

  NPD (past)
• Fedcap Rehabilitation Services, Inc.

  • Adult Mental Health Clinic/Center
  • Bronx, NY
  • NPI 1235374448

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1476316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715040000000",
    "number": "1962952929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "743 CLIFTON ST",
            "city": "FORKED RIVER",
            "state": "NJ",
            "postal_code": "087311323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "743 CLIFTON ST",
            "city": "FORKED RIVER",
            "state": "NJ",
            "postal_code": "087311323",
            "telephone_number": "609-401-2566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOKE",
        "first_name": "IVELISSES",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-10-13",
        "last_updated": "2024-05-07",
        "certification_date": "2024-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker",
            "state": "NY",
            "license": "104237",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "092959",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Community Options, Inc
• Community Options, Inc.
• Community Optionsenterprises, Inc
• Comprehensive Health Center, LLC
• Comprehensive Psychological and Wellness Center,LLC
• Linda Corbacho Trapani, BCBA
• Corbium Company
• Thomas Crespo
• Liviu C Crisan, MD
• Katelyn Cummings

• All providers in Forked River, NJ
• Clinical Social Worker in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2024; 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.