Individual
NILES COOK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
8245 BOONE BLVD STE 630, VIENNA, VA 22182-3894
(703) 261-9148
Mailing address
8245 BOONE BLVD STE 630, VIENNA, VA 22182-3894
(703) 261-9148
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
103T00000X
Psychologist
Primary
0810008468
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
210855
—
OR
Enumeration date
09/01/2011
Last updated
05/14/2026
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