MEDICARE: COOKE'S FOR KID'S

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	251S00000X	Community/Behavioral Health Agency
2	261QA0600X	Adult Day Care Clinic/Center
3	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)
4	171M00000X	Case Manager/Care Coordinator
5	251B00000X	Case Management Agency
6	101Y00000X	Counselor
7	101YP2500X	Professional Counselor
8	261QM0850X	Adult Mental Health Clinic/Center
9	261QM1300X	Multi-Specialty Clinic/Center
10	320800000X	Mental Illness Community Based Residential Treatment Facility
11	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1114857455
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COOKE'S FOR KID'S

Provider Business Mailing Address
First Line	:	230 NORTHLAND BLVD STE 217
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45246-3600
Country	:	US
Telephone Number	:	513-620-5924
Fax Number	:

Provider Business Practice Location Address
First Line	:	230 NORTHLAND BLVD STE 217
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45246-3600
Country	:	US
Telephone Number	:	513-620-5924
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	STEPHANIE JEAN COOKE
Credential	:	LPC, CDCA
Telephone Number	:	513-620-5924

Provider Enumeration Date	:	05/20/2026
Last Update Date	:	05/20/2026

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Directions to “COOKE'S FOR KID'S ” Practice Location

Language	Start Address	Practice Location

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