Individual
MRS. LINDA JOYCE COOK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD LCSW
Contact information
Practice address
13433 SE SOUTHWOOD DR, PRINEVILLE, OR 97754
(541) 350-0117
(866) 740-0637
Mailing address
13433 SE SOUTHWOOD DR, PRINEVILLE, OR 97754
(541) 350-0117
(866) 740-0637
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
L3381
OR
103TC1900X
Counseling Psychologist
Primary
—
—
1041C0700X
Clinical Social Worker
L3381
OR
1041C0700X
Clinical Social Worker
LW00007548
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
275397
—
OR
01
—
332339
MANAGED HEALTH NETWORK
—
01
—
74242700
MAGELLAN
—
01
—
838283000
BLUE CROSS
OR
01
—
J874101
PACIFIC SOURCE
OR
Enumeration date
08/31/2005
Last updated
09/06/2012
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