MRS. KELLY L S COOK LICSW
NPI 1790847135
Counselor - Mental Health in Edina, MN
About Mrs. Kelly L S Cook Licsw NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MRS. KELLY L S COOK LICSW (NPI 1790847135) is an individual mental health provider in Edina, Minnesota and active in the NPI registry since December 2006. She is enrolled in Medicare PECOS and is a graduate of Other (2002).
NPPES Registry Identity
Specialties & Licenses 2
Other Names 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Mrs. Kelly L S Cook Licsw is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Kelly Cook reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Edina, MN 55439
- Reassigned Medicare billing, Minnesota enrollment
- Medicare enrollment name: Affinity Psychological Services PC
- 136 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Areas of Expertise CMS Part B claims
Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
EDINA, MN 55439
EDINA, MN 55439
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Kelly Cook's NPI number?
The NPI number for Kelly Cook is 1790847135. It was assigned to this individual provider in the NPPES registry on December 14, 2006. The provider is also known as Kelly Lea Shepardson.
Where is Kelly Cook located?
Kelly Cook practices at 7401 Metro Blvd Ste 250, Edina, MN 55439. The listed phone number is (320) 403-4013.
What is Kelly Cook's specialty?
The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.
Is Kelly Cook enrolled in Medicare?
Yes. Kelly Cook is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Kelly Cook's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Kelly Cook reassigns Medicare benefits to Affinity Psychological Services, P.C. (Edina, MN). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kelly Cook's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Kelly Cook accept?
Health plans from HealthPartners list Kelly Cook as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Kelly Cook was last updated on November 20, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Mrs. Kelly L S Cook, LICSW · NPI 1790847135
Mental Health provider in Edina, Minnesota. Individual provider, active in the CMS NPPES registry since December 14, 2006.
## Identity
- **NPI:** 1790847135 (Entity type: Individual)
- **Enumerated:** December 14, 2006
- **Primary specialty:** Counselor - Mental Health · taxonomy 101YM0800X
- **Sole proprietor:** Yes
## Practice location
- **Address:** 7401 METRO BLVD STE 250, Edina, MN 55439-3062
- **Phone:** (320) 403-4013
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** Affinity Psychological Services, P.C. (NPI 1245610856, Edina, MN), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2002
## Record status
- **NPPES last updated:** November 20, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1790847135) · Data from the CMS NPPES public registry.