Individual
MR. NATHAN N COOK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
2145 W BROADWAY ST, IDAHO FALLS, ID 83402-2904
(307) 254-2321
Mailing address
4015 E 136 N, RIGBY, ID 83442-5198
(307) 254-2321
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1477716470
ORGANIZATION NATIONAL PROVIDER IDENTIFICATION NUMBER
WY
Enumeration date
03/12/2009
Last updated
11/10/2025
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