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NPI Code Detail

MEDICARE: MR. ASHLEY TRENT COOK LCSW

MEDICARE:  MR. ASHLEY TRENT COOK  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
11041C0700XClinical Social WorkerSW6981FL

General Provider Information

NPI Number : 1609947399
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. ASHLEY TRENT COOK LCSW
Provider Business Mailing Address
First Line : 9951 ATLANTIC BLVD
Second Line : SUITE 100B
City : JACKSONVILLE
State : FL
Zip : 32225-6584
Country : US
Telephone Number : 904-727-7778
Fax Number : 904-727-3921
Provider Business Practice Location Address
First Line : 9951 ATLANTIC BLVD
Second Line : SUITE 100B
City : JACKSONVILLE
State : FL
Zip : 32225-6584
Country : US
Telephone Number : 904-727-7778
Fax Number : 904-727-3921
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/13/2006
Last Update Date : 07/08/2007

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Directions to “ MR. ASHLEY TRENT COOK LCSW” Practice Location

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