Cooley, Dustin James

Cooley, Dustin James is an individual health care provider with primary practice located at 1805 E Walnut St , Columbia MO 65201-6425. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Social Worker, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Cooley, Dustin James can be contacted via phone (573) 777-7500.

Contact Information

Primary practice address
1805 E Walnut St Columbia MO 65201-6425
Phone: (573) 777-7500
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Social Worker 104100000X 2013025358 Missouri
Behavioral Health & Social Service Providers / Clinical 1041C0700X 2013025358 Missouri

Profile Details

NPI number 1134425994
LBN Legal business name Cooley, Dustin James
Credentials MSW, LCSW
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 26th, 2011
Last updated Sep 20th, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1134425994 NPPES
Missouri MEDICAID 494562002

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