Healthcare Provider Details

I. General information

NPI: 1073427704
Provider Name (Legal Business Name): REBECCA LYNNE VIGILANTE COOK MSW, LCSWA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/30/2026
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8212 VILLAGE HARBOR DR FL 2
CORNELIUS NC
28031-3706
US

IV. Provider business mailing address

5728 COLONIAL GARDEN DR
HUNTERSVILLE NC
28078-1210
US

V. Phone/Fax

Practice location:
  • Phone: 980-463-8445
  • Fax:
Mailing address:
  • Phone: 973-214-9845
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberP024702
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: