Providers

WILLIAM BRIAN COOK, LPCC

NPI 1396284394, individual, Ashland, KY, Counselor, Professional

4
Evidence tier
structure or single-organization volume
  • Hours beyond a day in 12 months, but with up to 1062 patients a month, which points to a supervising clinician on the claims rather than one person's hours.
  • Records needed.
score 51 of 100, rank 8643, $2.4M at stake

Hours billed per day

Medicaid billing converted into hours of hands-on care per day. The lower bound counts one unit per claim line and needs no price; the other two divide dollars by a unit price, the conservative one at 1.5 times the price. The clinician on the claim may be a supervisor under state rules, so billing organizations are counted too.

monthwhat was foundhours per day, lower boundhours per day, at pricehours per day, conservativeper working daypatientsbilling organizationscodespaid
Sep 2019More hours than a day holds, even counting one unit per claim line33.054.936.636.8899190791 90832 90834 90837 90853 99354 H0038 H2011 H2015 H2019$118K
Oct 2019More hours than a day holds, even counting one unit per claim line31.859.339.538.0873190791 90832 90834 90837 90853 99354 H0038 H2011 H2015 H2019$135K
Nov 2019More hours than a day holds, even counting one unit per claim line30.653.435.635.9842190791 90832 90834 90837 90853 99354 H0038 H2011 H2015 H2019$113K
Dec 2019More hours than a day holds at a conservative unit price27.752.334.833.9818190791 90832 90834 90837 90853 99354 H0038 H2011 H2015 H2019$111K
Jan 2020More hours than a day holds, even counting one unit per claim line40.071.147.442.31062190791 90832 90834 90837 90853 99354 H0038 H2011 H2015 H2019$148K
Feb 2020More hours than a day holds, even counting one unit per claim line35.069.046.043.9905190791 90832 90834 90837 90853 99354 H0038 H2011 H2015 H2019$132K
Mar 2020More hours than a day holds, even counting one unit per claim line34.060.740.438.6821190791 90832 90834 90837 90853 99354 H0038 H2011 H2015 H2019$123K
Apr 2020More hours than a day holds, even counting one unit per claim line31.356.237.539.2670190791 90832 90834 90837 90847 90853 H0038$107K
Sep 2020More hours than a day holds at a conservative unit price27.857.238.133.7686190791 90832 90834 90837 90846 90847 90853 H0038 H2011 H2015$115K
Jan 2021More hours than a day holds, even counting one unit per claim line33.451.334.234.5729190791 90832 90834 90837 90847 90853 H0038 H2011 H2015$109K
Mar 2021More hours than a day holds, even counting one unit per claim line31.357.338.237.3820190791 90832 90834 90837 90847 90853 99354 H0038 H2011 H2015$125K
Apr 2021More hours than a day holds at a conservative unit price27.549.533.033.1761190791 90832 90834 90837 90847 90853 H0038 H2011 H2015$101K

National provider registry

From the CMS NPPES Registry, refreshed daily.

NameWILLIAM BRIAN COOK, LPCC
TypeIndividual
StatusActive
NPI issuedFebruary 23, 2017, last updated June 25, 2019
Practice location1212 BATH AVE, 8TH FLOOR, Ashland, KY 41101-5422, 606-325-3005
Mailing addressPO BOX 790, Ashland, KY 41105-0790
Specialties
Counselor, Professional (101YP2500X, primary, license 248698 KY)

Procedures billed

The specific codes behind the dollars. Medicaid figures come from T-MSIS (2018 to 2024) and are compared with every other provider billing the same code; Medicare figures come from the 2024 physician and supplier file and compare this provider's submitted charge with what Medicare allowed, against the usual ratio for that code.

Medicaid, largest codes
codewhat it ispaidshareper patient-monthtypicalrank among providers
90837Psychotherapy, 1 hourhistory of abuse$964K25%$185$191 (top 5% from $442)47th percentile
T2023Medicaid service code$843K22%$330$332 (top 5% from $1K)48th percentile
H0038Self-help/peer services per 15 min$276K7%$164$147 (top 5% from $2K)54th percentile
90834Psychotherapy, 45 minutes$268K7%$114$101 (top 5% from $318)57th percentile
90832Psychotherapy, 30 minutes$249K7%$75$59 (top 5% from $239)66th percentile
90887Medicaid service code$249K7%$168$98 (top 5% from $270)80th percentile
H2015Comprehensive community support services per 15 minhistory of abuse$211K6%$344$344 (top 5% from $2K)50th percentile
90853Group psychotherapyhistory of abuse$134K4%$70$60 (top 5% from $332)57th percentile

In this area

6 providers in Boyd County, KY carry an indicator in the public record, with $11.4M at stake between them. The most common is more hours than a day holds, on 5 of them, followed by paid after a public list action on 1. 1 is tier 1: documented action, then payment.

tierproviderat stakewhy
1LANA WHITE
Ashland, KY, ranked 286
$10K
  • Listed on the KY Medicaid exclusion list since August 20, 2019.
  • Medicaid still paid claims in 1 later month, $10,185 in total.
4MANISH PARIKH
Ashland, KY, ranked 7582
$2.8M
  • Hours beyond a day in 13 months, but with up to 1230 patients a month, which points to a supervising clinician on the claims rather than one person's hours.
  • Records needed.
  • and 1 more
4SARAH HALCOMB-CLARK
Ashland, KY, ranked 8414
$4.9M
  • Hours beyond a day in 15 months, but with up to 1355 patients a month, which points to a supervising clinician on the claims rather than one person's hours.
  • Records needed.
4ERNEST BEHNKE
Ashland, KY, ranked 8894
$1.3M
  • Hours beyond a day in 7 months, but with up to 2316 patients a month, which points to a supervising clinician on the claims rather than one person's hours.
  • Records needed.
5MISTY GRISWOLD
Rush, KY, ranked 10915
$1.4M
5AMBER FRALEY
Ashland, KY, ranked 11057
$908K

Recent enforcement in KY

All releases

Department of Justice and HHS-OIG releases for this state, newest first. Each opens in a new tab.

DOJIndictedAug 27, 2026
Kentucky Medical Biller Indicted for Healthcare Fraud and Money Laundering Charges
Sanders recruited individuals to open behavioral health entities, handled their Kentucky Medicaid credentialing and enrollment, and directed submission of fraudulent Medicaid claims across ten behavioral health providers for services never provided, including for incarcerated, hospitalized, or deceased members, using licensed professionals' NPIs without authorization.
DOJChargedJun 23, 2026
5 Individuals and 2 Companies Charged as Part of Department of Justice National Health Care Fraud Takedown
Seven defendants were charged in four cases with schemes including billing Kentucky Medicaid for peer support and psychoeducation services that were fraudulent, unauthorized, or not rendered using providers' NPIs, using a DEA number to order controlled substances in others' names, credentialing a company with Medicare and billing for services not rendered using a doctor's NPI, and stealing controlled substances from hospitals and falsely documenting administration.
DOJCivil settlementJun 23, 2026
Civil Settlements Reached as Part of Department of Justice National Health Care Fraud Takedown
Three Home and Community Based Waiver providers and their owners, who had shared financial interests, referred Medicaid waiver beneficiaries for attendant care services and billed Medicaid for attendant care hours that were not fully provided or not provided at all.
DOJCivil judgmentMay 15, 2026
Operators of Day Treatment Program for Children Agree to $15.2 Million Civil Judgment to Resolve Medicaid Fraud Allegations
The Government alleged that from August 2022 through June 2025 the Recovery Centers sought Medicaid payments for time children spent on education, recreation, and lunch breaks at the Aspire Day Program and that Recovery Center of Kentucky falsely represented clinician qualifications to obtain higher reimbursements.
DOJSentencedApr 24, 2026
Former Sober Home Owner and Operator Sentenced for Kickback Conspiracy and Health Care Fraud
Jordan solicited and received kickbacks in exchange for referring urine drug testing from her sober home company to three labs, and Serenity Keepers billed Medicaid for peer support services not provided by licensed peer support specialists, with Williams reporting that residents received six hours of peer support services per day knowing that was not true.

Referral packet

The packet is a draft for a reviewer. It reads every public record behind this case, states what the records show with a citation for each finding, names the regulation each finding relates to, and lists the ordinary explanations to rule out first. It never asserts intent.

Ask this case

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