Doctor Name: | AMY JENNIFER COOK |
NPI Number: | 1710314570 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LMSW |
License Number: | 10050 |
Business Practice Address: | 103 North Kemper St Lake View, SC - 29563 |
Business Phone Number: | 8437592189 |
Business Fax Number: | |
Mailing Address: | Po Box 1090, HARTSVILLE |
State: | SC |
Postal Code: | 295511090 |
Phone Number: | 8438570111 |
Fax Number: | |
NPI Enumeration Date: | 10/10/2013 |
NPI Last Update Date: | 10/19/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 10050 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | SC |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |