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NPI Code Detail

MEDICARE: MADDISON PAIGE COOKE LMSW

MEDICARE: MADDISON PAIGE COOKE LMSW
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 Worker6801121436MI

General Provider Information

NPI Number : 1942029996
Entity Type Code : Individual
Provider Name (Legal Business Name) : MADDISON PAIGE COOKE LMSW
Provider Business Mailing Address
First Line : 300 68TH ST SE
Second Line :
City : GRAND RAPIDS
State : MI
Zip : 49548-6927
Country : US
Telephone Number : 616-570-5753
Fax Number :
Provider Business Practice Location Address
First Line : 300 68TH ST SE
Second Line :
City : GRAND RAPIDS
State : MI
Zip : 49548-6927
Country : US
Telephone Number : 616-570-5753
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/07/2024
Last Update Date : 01/07/2026

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Directions to “ MADDISON PAIGE COOKE LMSW” Practice Location

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