Provider Demographics
NPI:1326580861
Name:COOK, CAROLYN (LPC)
Entity type:Individual
Prefix:
First Name:CAROLYN
Middle Name:
Last Name:COOK
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 SUNSET LN
Mailing Address - Street 2:SUITE 2131
Mailing Address - City:CULPEPER
Mailing Address - State:VA
Mailing Address - Zip Code:22701-3376
Mailing Address - Country:US
Mailing Address - Phone:540-825-3117
Mailing Address - Fax:
Practice Address - Street 1:1200 SUNSET LN
Practice Address - Street 2:SUITE 2131
Practice Address - City:CULPEPER
Practice Address - State:VA
Practice Address - Zip Code:22701-3376
Practice Address - Country:US
Practice Address - Phone:540-825-3117
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-15
Last Update Date:2016-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701006850101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional