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Individual
TAMMY BLACKARD COOK
Active
Individual
TAMMY BLACKARD COOK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C004059
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
017WX
BCBS GROUP NUMBER
NC
01
—
131UE
BCBS PROVIDER #
NC
05
—
6007268
—
NC
Enumeration date
05/24/2006
Last updated
05/21/2012
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