Ms Shawandalyn Latrelle Cooley, LCSW in Jacksonville, NC

Ms Shawandalyn Latrelle Cooley, LCSW is a medicare enrolled "Social Worker - Clinical" provider in Jacksonville, North Carolina. Her current practice location is 825 Gum Branch Rd, Suite 133, Jacksonville, North Carolina. You can reach out to her office (for appointments etc.) via phone at (910) 346-6726.

Ms Shawandalyn Latrelle Cooley is licensed to practice in Virginia (license number 0904009596) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1376608653.

Contact Information

	Ms Shawandalyn Latrelle Cooley, LCSW
	825 Gum Branch Rd, Suite 133, Jacksonville, NC 28540-6298
	(910) 346-6726
	(910) 346-8285

Map and Direction

Healthcare Provider's Profile

Full Name	Ms Shawandalyn Latrelle Cooley
Gender	Female
Speciality	Social Worker - Clinical
Location	825 Gum Branch Rd, Jacksonville, North Carolina
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1376608653
Provider Enumeration Date: 12/27/2006
Last Update Date: 07/24/2025

Medicare PECOS Information:

PECOS PAC ID: 5799879037
Enrollment ID: I20211007003441

Medical Identifiers

Medical identifiers for Ms Shawandalyn Latrelle Cooley such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1376608653	NPI	-	NPPES
8300057B	Medicaid	NC

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
1041C0700X	Social Worker - Clinical	24269 (Maryland)	Secondary
1041C0700X	Social Worker - Clinical	0904009596 (Virginia)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Ms Shawandalyn Latrelle Cooley allows following entities to bill medicare on her behalf.

Entity Name	Axis Healthcare Group
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1326295098 PECOS PAC ID: 1254409550 Enrollment ID: O20120919000403

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Ms Shawandalyn Latrelle Cooley is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Ms Shawandalyn Latrelle Cooley, LCSW 8040 Georgia Ave Ste 170, Silver Spring, MD 20910-4959 Ph: (202) 360-4787	Ms Shawandalyn Latrelle Cooley, LCSW 825 Gum Branch Rd, Suite 133, Jacksonville, NC 28540-6298 Ph: (910) 346-6726

Reviews and Comments

Social Worker in Jacksonville, NC

Jessica Smith, MSW,LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 215 Memorial Dr, Jacksonville, NC 28546 Phone: 910-353-5118
Amanda Ashley Manning, LCSW-A Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 200 Tarpon Trl, Jacksonville, NC 28546 Phone: 910-938-1114 Fax: 910-938-1118
Elise Cowart, MSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 445 Western Blvd Ste Q, Jacksonville, NC 28546 Phone: 910-858-5848
Portia Adams, LCSW-A Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 110 Branchwood Dr Ste B, Jacksonville, NC 28546 Phone: 910-938-9833
Ms. Tatianna Brooks, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 231 New Bridge St, Jacksonville, NC 28540 Phone: 910-915-9155 Fax: 910-939-5484
Nicole Marie Polidoro, LCSW-A Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 200 Tarpon Trl, Jacksonville, NC 28546 Phone: 910-938-1114 Fax: 910-938-1118
Shirby Durant, LCSWA, LCASA Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 231 Memorial Dr, Jacksonville, NC 28546 Phone: 910-353-5354

Ms Shawandalyn Latrelle Cooley, LCSW - Medicare Clinical Social Worker in Jacksonville, NC