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NPI Code Detail

MEDICARE: KORI GRACE COOK LMSW, LCDC

MEDICARE: KORI GRACE COOK LMSW, LCDC
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 Worker113898TX
2101YA0400XAddiction (Substance Use Disorder) Counselor17742TX

General Provider Information

NPI Number : 1306676390
Entity Type Code : Individual
Provider Name (Legal Business Name) : KORI GRACE COOK LMSW, LCDC
Provider Business Mailing Address
First Line : 12301 MAIN ST
Second Line :
City : HOUSTON
State : TX
Zip : 77035-6207
Country : US
Telephone Number : 713-275-5400
Fax Number :
Provider Business Practice Location Address
First Line : 12301 MAIN ST
Second Line :
City : HOUSTON
State : TX
Zip : 77035-6207
Country : US
Telephone Number : 713-275-5400
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/05/2024
Last Update Date : 04/07/2026

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Directions to “ KORI GRACE COOK LMSW, LCDC” Practice Location

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