Healthcare Provider Details

I. General information

NPI: 1720223464
Provider Name (Legal Business Name): CYNTHIA K COOK-WION LICDC-CS, LISW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/10/2008
Last Update Date: 06/05/2023
Certification Date: 06/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 WALNUT ST GREENVILLE
GREENVILLE OH
45331-1944
US

IV. Provider business mailing address

600 WALNUT ST GREENVILLE
GREENVILLE OH
45331-1944
US

V. Phone/Fax

Practice location:
  • Phone: 937-548-6842
  • Fax: 937-548-8938
Mailing address:
  • Phone: 937-548-6842
  • Fax: 937-548-8938

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number933501
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberI.2304409
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: