Provider Demographics
NPI:1972233260
Name:COOK, SEMICHEAL (MS, ALC)
Entity type:Individual
Prefix:MS
First Name:SEMICHEAL
Middle Name:
Last Name:COOK
Suffix:
Gender:F
Credentials:MS, ALC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3901 MICHAEL BLVD APT 2015
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36609-1848
Mailing Address - Country:US
Mailing Address - Phone:251-615-1233
Mailing Address - Fax:
Practice Address - Street 1:28851 N MAIN ST STE B
Practice Address - Street 2:
Practice Address - City:DAPHNE
Practice Address - State:AL
Practice Address - Zip Code:36526-7273
Practice Address - Country:US
Practice Address - Phone:251-615-1233
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-10
Last Update Date:2022-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALC4090A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health