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General NPI Number Information
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NPI Number | 1952196768
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Entity Type | Individual
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Provider Name | CLAYTON COOK
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Gender | Male
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Dates
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Enumeration Date | 04/11/2025
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Last Update Date | 09/09/2025
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Provider Practice Location Address
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Address Line | 6610 SE QUAKERVALE RD
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City | RIVERTON
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State | KS
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Zip | 66770-4185
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Country | US
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Telephone | 620-848-2300
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Fax |
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Provider Business Mailing Address
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Address Line | 1535 W 15TH ST FL 3
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City | LAWRENCE
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State | KS
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Zip | 66045-7608
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Country | US
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Telephone | 785-864-4720
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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 | 14139
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License Number State | KS
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