Provider Demographics
NPI:1588063663
Name:COOKE, CATHY G (PSYD)
Entity type:Individual
Prefix:
First Name:CATHY
Middle Name:G
Last Name:COOKE
Suffix:
Gender:
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:633RD MEDICAL GROUP
Mailing Address - Street 2:72 NEALY AVENUE
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23606
Mailing Address - Country:US
Mailing Address - Phone:757-225-6727
Mailing Address - Fax:
Practice Address - Street 1:633RD MEDICAL GROUP
Practice Address - Street 2:77 NEALY AVE
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23665
Practice Address - Country:US
Practice Address - Phone:757-225-6727
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-14
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist