Organization
COOK COUNSELING SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KELLY L.S. COOK LICSW (OWNER)
(320) 223-0503
Entity
Organization
Contact information
Practice address
101 7TH AVE S STE 200, SAINT CLOUD, MN 56301-5010
(320) 223-0503
Mailing address
PO BOX 2071, SAINT CLOUD, MN 56302-2071
(320) 223-0503
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1790847135
INDIVIDUAL NPI
MN
Enumeration date
10/16/2008
Last updated
10/16/2008
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