MRS. KELLY L S COOK (LICSW) – Mental Health Counselor, NPI 1790847135

MRS. KELLY L S COOK (LICSW) is a healthcare provider. based in St cloud, Minnesota. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LICSW. They hold a License No. 17541 (MN). The NPI Number for MRS. KELLY L S COOK (LICSW) is 1790847135

Main info

Female
Sole Proprietor
24 Years Of Experience
Name
MRS. KELLY L S COOK (LICSW)
NPI
1790847135
Phone
(320) 252-5010
Address
1321 13TH ST N
Enumeration Date
14 December 2006
Last Update Date
20 November 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6122685858
Graduation Year
2002 (24 years ago)
PAC ID
7517062201
Group Practice PAC ID
0749528552
Professional Enrollment ID
I20070425000472
Address ID
MN563031924SA3400XNXXX401
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience67
Completeness75
Years active:19State licenses:1Digital endpointsOther names

2,310 CLINICAL SOCIAL WORKER in MN

Provider Addresses for MRS. KELLY L S COOK (LICSW)

  • 1321, 13th Street North, St. Cloud, Stearns County, Minnesota, 56303, United States

    ST CLOUD, MN 563032614

    Phone: (320) 252-5010

    Fax: (320) 203-1855

    Type: Mailing

  • 7401 METRO BLVD STE 250

    EDINA, MN 554393062

    Phone: (320) 403-4013

    Type: Location

  • 2700 1ST ST N STE 100

    SAINT CLOUD, MN 563034585

    Phone: (320) 223-0503

    Fax: (800) 692-2098

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2007-04-25

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20070425000472IClinical Social WorkerMNTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
90837Psychotherapy, 1 hour33519$0
View full utilization report →

Insurance plans in this area (ZIP 56303)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0749528552View full group profile
NameSpecialtyState
Mental Health CounselorMN
Mental Health CounselorMN
Clinical PsychologistMN
Mental Health CounselorMN
Clinical Social WorkerMN
Clinical Social WorkerMN
Marriage And Family TherapistMN
Mental Health CounselorMN
Marriage And Family TherapistMN
Marriage And Family TherapistMN

Reviews

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Frequently asked questions

Can I cross-check MRS. KELLY L S COOK (LICSW) using NPI 1790847135?
NPI 1790847135 belongs to MRS. KELLY L S COOK (LICSW); compare other details if you need extra assurance.
Is MRS. KELLY L S COOK (LICSW) still an active registrant?
MRS. KELLY L S COOK (LICSW) carries an active NPI according to the public dataset.
How would a patient describe MRS. KELLY L S COOK (LICSW)'s focus?
For MRS. KELLY L S COOK (LICSW), the primary taxonomy reads as Mental Health Counselor. Clinical services aligned with this taxonomy classification.
Where in Minnesota is MRS. KELLY L S COOK (LICSW) registered?
Use St Cloud, Minnesota as the headline location for MRS. KELLY L S COOK (LICSW) here.
Does MRS. KELLY L S COOK (LICSW) accept insurance?
Insurance participation is not part of the core NPI extract — call the plan or office to confirm.

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