Healthcare Provider Details

I. General information

NPI: 1144922824
Provider Name (Legal Business Name): BART DOUGLAS COOK LCSW, JD, MSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/20/2023
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1135 STRAND AVE STE B
MISSOULA MT
59801-5678
US

IV. Provider business mailing address

101 RIMROCK WAY
MISSOULA MT
59803-2305
US

V. Phone/Fax

Practice location:
  • Phone: 406-229-8988
  • Fax:
Mailing address:
  • Phone: 970-232-4515
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberBBH-LCSW-LIC-81694
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: