MEDICARE: CELESTINE COOKSON LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	CSW010333	GA

General Provider Information

NPI Number	:	1225605348
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CELESTINE COOKSON LCSW

Provider Business Mailing Address
First Line	:	2751 BUFORD HWY NE STE 402
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30324-5456
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2751 BUFORD HWY NE STE 402
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30324-5456
Country	:	US
Telephone Number	:	678-826-2801
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/08/2021
Last Update Date	:	05/22/2026

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