Provider Demographics
NPI:1962167429
Name:COOKE, LINDSAY (BCBA)
Entity type:Individual
Prefix:
First Name:LINDSAY
Middle Name:
Last Name:COOKE
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:644 N MAIN ST UNIT 304
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29601-1691
Mailing Address - Country:US
Mailing Address - Phone:704-582-2969
Mailing Address - Fax:
Practice Address - Street 1:644 N MAIN ST UNIT 304
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29601-1691
Practice Address - Country:US
Practice Address - Phone:704-582-2969
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-01
Last Update Date:2021-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst