Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Kelly Cook, LICSW

Individual provider Clinical Social Worker · NPI 1073810669

Kelly Cook, LICSW is a Clinical Social Worker in Port Angeles, Washington. Qualified in 2008, 18 years ago. Practices with Peninsula Behavioral Health, a 20-clinician group and accepts Medicare assignment. Licensed in South Carolina and Washington.

Years since qualifying
18
Licensed in
SC, WA
In the registry since
2011
Specialties on file
2
What do these letters mean?
LICSW — Licensed Independent Clinical Social Worker
The title some states use for an independently practising clinical social worker.

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Practice location Address checks out

118 E 8th St
Port Angeles, WA 98362-6129
Phone: (360) 457-0431
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence LW60384294 (WA)
Clinical Social Worker Taxonomy 1041C0700X · Licence 9685 (SC)

Record details

NPI number1073810669
Entity typeIndividual (Type 1)
GenderFemale
Credentials LICSW
Sole proprietorNo
NPI enumeratedFebruary 17, 2011
Last updated in NPPESJuly 24, 2014

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2008 (18 years in practice)
Group practice Peninsula Behavioral Health — 20 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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