Individual
MR. JOHN ALLAN COOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
1363 W SPRUCE AVE, WASILLA, AK 99654
(907) 376-2411
(907) 352-3363
Mailing address
1363 W SPRUCE AVE, WASILLA, AK 99654
(907) 376-2411
(907) 352-3363
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
NC
101YM0800X
Mental Health Counselor
C005914
NC
1041C0700X
Clinical Social Worker
Primary
CSWS381
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
561949434
BCBS
NC
Enumeration date
02/07/2008
Last updated
03/15/2017
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