Provider Demographics
NPI:1386072726
Name:COOKSEY, LILIAN L (PSYD)
Entity type:Individual
Prefix:DR
First Name:LILIAN
Middle Name:L
Last Name:COOKSEY
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4010 DUPONT CIR
Mailing Address - Street 2:SUITE L-09
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40207-4812
Mailing Address - Country:US
Mailing Address - Phone:469-324-9686
Mailing Address - Fax:
Practice Address - Street 1:4010 DUPONT CIR
Practice Address - Street 2:SUITE L-09
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207-4812
Practice Address - Country:US
Practice Address - Phone:469-324-9686
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-10-22
Last Update Date:2015-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYPSYLIP00212075103T00000X
TX36293103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist