Individual
IVELISSES COOKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
743 CLIFTON ST, FORKED RIVER, NJ 08731-1323
(609) 401-2566
Mailing address
743 CLIFTON ST, FORKED RIVER, NJ 08731-1323
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
104237
NY
1041C0700X
Clinical Social Worker
Primary
092959
NY
Other
Enumeration date
10/13/2016
Last updated
05/07/2024
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