Healthcare Provider Details

I. General information

NPI: 1952228959
Provider Name (Legal Business Name): CHRISTOPHER E COOK
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/01/2026
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5577 AIRPORT HWY STE 102
TOLEDO OH
43615-7364
US

IV. Provider business mailing address

5577 AIRPORT HWY STE 102
TOLEDO OH
43615-7364
US

V. Phone/Fax

Practice location:
  • Phone: 419-720-0442
  • Fax: 419-754-2085
Mailing address:
  • Phone: 419-720-0442
  • Fax: 419-754-2085

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCDCAPRE.195230
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: