Provider Demographics
NPI:1306956560
Name:MUNDEE-COOK, IRENE ANNE (MSW LCSW)
Entity type:Individual
Prefix:MS
First Name:IRENE
Middle Name:ANNE
Last Name:MUNDEE-COOK
Suffix:
Gender:F
Credentials:MSW LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1746 CLOISTER DRIVE
Mailing Address - Street 2:#6
Mailing Address - City:CROSBY
Mailing Address - State:TX
Mailing Address - Zip Code:77532-5434
Mailing Address - Country:US
Mailing Address - Phone:281-328-4353
Mailing Address - Fax:281-462-1014
Practice Address - Street 1:1746 CLOISTER DRIVE
Practice Address - Street 2:#6
Practice Address - City:CROSBY
Practice Address - State:TX
Practice Address - Zip Code:77532-5434
Practice Address - Country:US
Practice Address - Phone:281-328-4353
Practice Address - Fax:281-462-1014
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXLCSW01082104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
00S62WMedicare ID - Type Unspecified