Individual
MS. CASEY L COOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
167 POLK STREET, SUITE 300, WATERTOWN, NY 13601-2770
(315) 782-7445
(315) 779-1184
Mailing address
PO BOX 6550, 167 POLK STREET, SUITE 300, WATERTOWN, NY 13601-6550
(315) 782-7445
(315) 779-1184
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
NY
1041C0700X
Clinical Social Worker
Primary
095113
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02921011
—
NY
Enumeration date
08/26/2008
Last updated
09/29/2015
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