Kelly L S Cook, LICSW
NPI 1790847135ActiveIndividual· Counselor, Mental Health· Edina, MN
Counselor, Mental Health (LICSW) with Affinity Psychological Services PC, practicing in Edina, Minnesota. Medicare paid $14,104 for services to 13 patients in 2024.
Overview
| NPI | 1790847135 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | LICSW |
| Sole proprietor | Yes |
| NPI issued | Dec 14, 2006 |
| Last updated in NPPES | Nov 20, 2024 |
| Certified by provider | Nov 20, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Counselor, Mental Health Primary | 101YM0800X | — | — |
| Social Worker, Clinical | 1041C0700X | 17541 | MN |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Clinical Social Worker (MN) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 13 |
|---|---|
| Services billed | 184 across 5 procedure codes |
| Paid by Medicare | $14,104 |
Education and affiliations
| Graduation year | 2002 |
|---|---|
| Medicare specialty | Clinical Social Worker |
| Telehealth | Offers telehealth |
Medical group
- Affinity Psychological Services PCSaint Cloud, MN · 69 clinicians
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