Healthcare Provider Details

I. General information

NPI: 1891038592
Provider Name (Legal Business Name): NAILAH COOK LCSW, LCSW-C, LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/01/2013
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 MERCANTILE LN STE 136C
LARGO MD
20774-5332
US

IV. Provider business mailing address

14605 ELM ST UNIT 365
UPPER MARLBORO MD
20773-7516
US

V. Phone/Fax

Practice location:
  • Phone: 301-385-1235
  • Fax:
Mailing address:
  • Phone: 301-385-1235
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0904007938
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number24114
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLC50080789
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: