MEDICARE: MR. BART DOUGLAS COOK LCSW, JD, MSW

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
1	1041C0700X	Clinical Social Worker	BBH-LCSW-LIC-81694	MT

General Provider Information

NPI Number	:	1144922824
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. BART DOUGLAS COOK LCSW, JD, MSW

Provider Business Mailing Address
First Line	:	101 RIMROCK WAY
Second Line	:
City	:	MISSOULA
State	:	MT
Zip	:	59803-2305
Country	:	US
Telephone Number	:	970-232-4515
Fax Number	:

Provider Business Practice Location Address
First Line	:	1135 STRAND AVE STE B
Second Line	:
City	:	MISSOULA
State	:	MT
Zip	:	59801-5678
Country	:	US
Telephone Number	:	406-229-8988
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/20/2023
Last Update Date	:	12/10/2025

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