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General NPI Number Information
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NPI Number | 1326186818
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Entity Type | Individual
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Provider Name | NANCY ELIZABETH COOK LICSW
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Gender | Female
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Dates
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Enumeration Date | 02/05/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1 STEELE ST SUITE 113
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City | BURLINGTON
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State | VT
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Zip | 05401-6204
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Country | US
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Telephone | 802-862-2383
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Fax |
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Provider Business Mailing Address
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Address Line | 94 S MAPLE ST
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City | VERGENNES
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State | VT
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Zip | 05491-1221
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Country | US
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Telephone | 802-349-6269
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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 | 089-0001073
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License Number State | VT
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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 | 0904005243
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License Number State | VA
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