Individual
MS. CRISTAL LYNN COOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
459 BAUER AVENUE, MANCOS, CO 81328
(720) 710-6472
Mailing address
PO BOX 539, MANCOS, CO 81328-0539
(720) 710-6472
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
C053700518
CA
1041C0700X
Clinical Social Worker
Primary
306
CO
1041C0700X
Clinical Social Worker
LCSW-20768
AZ
Other
Enumeration date
10/24/2005
Last updated
12/16/2022
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