Provider Demographics
NPI:1326841628
Name:COOK, IMAN NIKOLE
Entity type:Individual
Prefix:
First Name:IMAN
Middle Name:NIKOLE
Last Name:COOK
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4811 TOWER RD APT C
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27410-5825
Mailing Address - Country:US
Mailing Address - Phone:336-404-3690
Mailing Address - Fax:
Practice Address - Street 1:201 ALMA PINNIX DR
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27405-4398
Practice Address - Country:US
Practice Address - Phone:336-404-3690
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-31
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool