1942323159 NPI number — MS. KAREN MARIE COOK MSW

Table of content: MS. KAREN MARIE COOK MSW (NPI 1942323159)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1942323159 NPI number — MS. KAREN MARIE COOK MSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
COOK
Provider First Name:
KAREN
Provider Middle Name:
MARIE
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
MSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
COOK
Provider Other First Name:
KARENMARIE
Provider Other Middle Name:
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
LCSW
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1942323159
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 130831
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HOUSTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77219-0831
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
832-778-1642
Provider Business Mailing Address Fax Number:
832-778-1642

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1100 MACARTHUR ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ROSENBERG
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77471-3640
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
281-342-3500
Provider Business Practice Location Address Fax Number:
832-778-1642
Provider Enumeration Date:
04/10/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  09392 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0406118-02 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




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