=====================================================
General NPI Number Information
=====================================================
NPI Number | 1609669290
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | COOK MENTAL HEALTH COUNSELING, PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/27/2025
-----------------------------------------------------
Last Update Date | 05/27/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 737 DELAWARE AVE STE 216
-----------------------------------------------------
City | BUFFALO
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 14209-2260
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 716-322-6394
-----------------------------------------------------
Fax | 716-322-6501
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 737 DELAWARE AVE STE 216
-----------------------------------------------------
City | BUFFALO
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 14209-2260
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 716-322-6394
-----------------------------------------------------
Fax | 716-322-6501
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/ DIRECTOR
-----------------------------------------------------
Name | DANIELLE COOK
-----------------------------------------------------
Credential | MS, LMHC-D
-----------------------------------------------------
Telephone | 716-322-6394
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------