Provider Demographics
NPI:1215103031
Name:BARBARA COOK
Entity type:Organization
Organization Name:BARBARA COOK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:S
Authorized Official - Last Name:COOK
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW PA
Authorized Official - Phone:813-875-0122
Mailing Address - Street 1:4144 N ARMENIA AVE STE 301
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33607-6440
Mailing Address - Country:US
Mailing Address - Phone:813-875-0122
Mailing Address - Fax:813-875-0208
Practice Address - Street 1:4144 N ARMENIA AVE STE 301
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607-6440
Practice Address - Country:US
Practice Address - Phone:813-875-0122
Practice Address - Fax:813-875-0208
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-01
Last Update Date:2008-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW71891041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK5810Medicare PIN