Individual
DEBORAH COOK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
28 SARIAH LANE, ONSET, MA 02558-0222
(404) 862-3413
Mailing address
411 WALNUT ST. PMB 6732, GREEN COVE SPRINGS, FL 32043
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
118451-SW-LICSW
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00000000000
I AM PRESENTLY UNEMPLOYED. I AM APPLYING FOR AN NPI TO RENEW MY LICSW LICENSE.
—
Enumeration date
11/06/2018
Last updated
11/06/2018
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