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NPI Code Detail

MEDICARE: MS. JENNIFER COOK LCSW

MEDICARE: MS. JENNIFER COOK LCSW
Medicare Provider Information

Scope of Practice

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

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerCSW002489GA

General Provider Information

NPI Number : 1114909306
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. JENNIFER COOK LCSW
Provider Business Mailing Address
First Line : 2540 WINDY HILL RD SE
Second Line :
City : MARIETTA
State : GA
Zip : 30067-8605
Country : US
Telephone Number : 770-644-1570
Fax Number : 770-644-1576
Provider Business Practice Location Address
First Line : 2540 WINDY HILL RD SE
Second Line :
City : MARIETTA
State : GA
Zip : 30067-8605
Country : US
Telephone Number : 770-644-1570
Fax Number : 770-644-1576
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/15/2005
Last Update Date : 10/03/2014

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Directions to “ MS. JENNIFER COOK LCSW” Practice Location

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