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General NPI Number Information
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NPI Number | 1659049781
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Entity Type | Individual
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Provider Name | SAMANTHA COOK MSW, LSCW
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Gender | Female
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Dates
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Enumeration Date | 09/02/2021
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Last Update Date | 08/20/2025
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Provider Practice Location Address
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Address Line | 1000 N BROADWAY
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City | PERU
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State | IN
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Zip | 46970-1070
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Country | US
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Telephone | 574-722-5151
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Fax | 574-739-1414
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Provider Business Mailing Address
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Address Line | 3517 S 500 E
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City | MARION
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State | IN
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Zip | 46953-9582
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Country | US
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Telephone | 765-618-6372
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 99106348A
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License Number State | IN
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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 | 34010806A
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License Number State | IN
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