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NPI Code Detail

MEDICARE: MRS. LINDA JEAN COOKE MSW, LCSW, BCD

MEDICARE:  MRS. LINDA JEAN COOKE  MSW, LCSW, BCD
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 WorkerLC9407ME
21041C0700XClinical Social Worker1022921MA

General Provider Information

NPI Number : 1770581407
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. LINDA JEAN COOKE MSW, LCSW, BCD
Provider Business Mailing Address
First Line : 11 MAIN ST
Second Line : SUITE 2
City : KENNEBUNK
State : ME
Zip : 04043-7005
Country : US
Telephone Number : 207-467-9092
Fax Number : 888-467-9205
Provider Business Practice Location Address
First Line : 11 MAIN ST
Second Line : SUITE 2
City : KENNEBUNK
State : ME
Zip : 04043-7005
Country : US
Telephone Number : 207-467-9092
Fax Number : 888-467-9205
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/07/2005
Last Update Date : 04/05/2013

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Directions to “ MRS. LINDA JEAN COOKE MSW, LCSW, BCD” Practice Location

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