MEDICARE: MRS. APRIL MAE COOK LPC

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	101YP2500X	Professional Counselor	0701008261	VA

General Provider Information

NPI Number	:	1538727003
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. APRIL MAE COOK LPC

Provider Business Mailing Address
First Line	:	10120 FRANCIS FOLSOM DR
Second Line	:
City	:	KING GEORGE
State	:	VA
Zip	:	22485-7058
Country	:	US
Telephone Number	:	843-754-2249
Fax Number	:

Provider Business Practice Location Address
First Line	:	4820 SOUTHPOINT DR STE 105
Second Line	:
City	:	FREDERICKSBURG
State	:	VA
Zip	:	22407-2605
Country	:	US
Telephone Number	:	540-358-8677
Fax Number	:

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

Provider Enumeration Date	:	05/30/2019
Last Update Date	:	05/30/2019

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