Provider Demographics
NPI:1427790179
Name:COOKS, ASHLEY RENEE (ALC)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:RENEE
Last Name:COOKS
Suffix:
Gender:F
Credentials:ALC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 VULCAN RD STE 300
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35209-4701
Mailing Address - Country:US
Mailing Address - Phone:205-202-1618
Mailing Address - Fax:
Practice Address - Street 1:105 VULCAN RD STE 300
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35209-4701
Practice Address - Country:US
Practice Address - Phone:205-202-1618
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-12
Last Update Date:2022-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALC3874A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health