MEDICARE: ANN SHEILA 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
1	1041C0700X	Clinical Social Worker	000945	FL
2	1041C0700X	Clinical Social Worker	073314-1	NY

General Provider Information

NPI Number	:	1841356730
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANN SHEILA COOK LCSW

Provider Business Mailing Address
First Line	:	4212 ROBIN HOOD RD
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32210-5827
Country	:	US
Telephone Number	:	904-384-4977
Fax Number	:

Provider Business Practice Location Address
First Line	:	4212 ROBIN HOOD RD
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32210-5827
Country	:	US
Telephone Number	:	904-384-4977
Fax Number	:

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

Provider Enumeration Date	:	12/28/2006
Last Update Date	:	03/29/2026

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