Individual
LILY A COOK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC, CADC I
Contact information
Practice address
2505 SE 11TH AVE, STE 232, PORTLAND, OR 97202-1062
(503) 285-0013
(855) 820-1151
Mailing address
2505 SE 11TH AVE, STE 232, PORTLAND, OR 97202-1062
(503) 285-0013
(855) 820-1151
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
C2671
OR
101YA0400X
Addiction (Substance Use Disorder) Counselor
C2671
OR
101YM0800X
Mental Health Counselor
C2671
OR
101YP2500X
Professional Counselor
C2671
OR
Other
Enumeration date
07/08/2010
Last updated
08/16/2012
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