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Individual

JILL COOKE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LADC

Contact information

Practice address
1 LONG WHARF DR, NEW HAVEN, CT 06511-5991
(203) 781-4600
(203) 781-4624
Mailing address
1 LONG WHARF DR, NEW HAVEN, CT 06511-5991
(203) 781-4600
(203) 781-4624

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1605
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
004041000
CT
05
008003745
CT
05
008135172
CT
Enumeration date
05/06/2025
Last updated
05/29/2025
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