| Marty T Cooke, LCPC | |
|
500 S 11th Ave, Suite 302, Pocatello, ID 83201-4835 | |
| (208) 233-0150 | |
| (208) 233-0159 |
| Full Name | Marty T Cooke |
|---|---|
| Gender | Male |
| Speciality | Mental Health Counselor |
| Experience | 24 Years |
| Location | 500 S 11th Ave, Pocatello, Idaho |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831246594 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | LCPC3448 (Idaho) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Human Supports Of Idaho | 0244485894 | 18 |
| Entity Name | Human Supports Of Idaho |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1922340124 PECOS PAC ID: 0244485894 Enrollment ID: O20130305000118 |
| Entity Name | Behavioral Health Solutions Of Idaho |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1164286092 PECOS PAC ID: 7012453830 Enrollment ID: O20240729001133 |
| Mailing Address | Practice Location Address |
|---|---|
| Marty T Cooke, LCPC Po Box 4986, Pocatello, ID 83205-4986 Ph: (208) 233-0150 | Marty T Cooke, LCPC 500 S 11th Ave, Suite 302, Pocatello, ID 83201-4835 Ph: (208) 233-0150 |
Ms. Dedra Christine Sanna, LCPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 409 Washington Ave, Pocatello, ID 83201 Phone: 208-234-2646 Fax: 208-232-0035 | |
Courtney Moore, Counselor Medicare: Not Enrolled in Medicare Practice Location: 2055 Garrett Way, Ste 2, Pocatello, ID 83201 Phone: 208-233-7832 | |
Lisa Hall, Counselor Medicare: Not Enrolled in Medicare Practice Location: 101 S Main St, Pocatello, ID 83204 Phone: 208-232-8840 | |
Ms. Rit Larae Nauman, LCPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 3330 Highway 30 W, Pocatello, ID 83201 Phone: 208-234-9100 Fax: 208-234-9104 | |
Michael L Stevens, LCSW Counselor Medicare: Accepting Medicare Assignments Practice Location: 109 N Arthur Ave Ste 203, Pocatello, ID 83204 Phone: 208-234-4673 Fax: 208-234-4677 | |
Mrs. Cassidy Michelle Roske, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 409 Washington Ave, Pocatello, ID 83201 Phone: 208-234-2646 Fax: 208-232-0035 | |
Matthew R Christensen, LCSW Counselor Medicare: Medicare Enrolled Practice Location: 5230 W Moonlight Mine Rd., Pocatello, ID 83201 Phone: 208-351-3956 |