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General NPI Number Information
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NPI Number | 1134054851
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Entity Type | Individual
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Provider Name | ELISSE COOK LCSW
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Gender | Female
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Dates
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Enumeration Date | 06/15/2026
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Last Update Date | 06/15/2026
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Provider Practice Location Address
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Address Line | 4848 S COMMERCE DR
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City | MURRAY
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State | UT
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Zip | 84107-4761
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Country | US
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Telephone | 801-266-2813
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Fax |
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Provider Business Mailing Address
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Address Line | 762 W SUNNY RIVER RD APT 1523
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City | TAYLORSVILLE
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State | UT
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Zip | 84123-2876
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Country | US
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Telephone | 248-515-7639
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 7581710
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License Number State | ID
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 13623614-3501
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License Number State | UT
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