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General NPI Number Information
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NPI Number | 1750872495
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Entity Type | Individual
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Provider Name | CRYSTAL COOKMAN PSY.D.
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Gender | Female
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Dates
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Enumeration Date | 05/29/2018
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Last Update Date | 04/18/2025
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Provider Practice Location Address
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Address Line | 814 ELM ST
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City | MANCHESTER
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State | NH
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Zip | 03101-2130
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Country | US
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Telephone | 603-860-0623
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 400
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City | ANDOVER
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State | MA
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Zip | 01810-0007
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Country | US
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Telephone | 978-272-0633
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 10852
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 10756
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License Number State | MA
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Taxonomy #3
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Taxonomy Code | 103TF0200X
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Taxonomy Name | Forensic Psychologist
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License Number | 1505
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License Number State | NH
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