1578517348 NPI number — MR. SCOTT PATRICK COOK MSW

Table of content: MR. SCOTT PATRICK COOK MSW (NPI 1578517348)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1578517348 NPI number — MR. SCOTT PATRICK COOK MSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
COOK
Provider First Name:
SCOTT
Provider Middle Name:
PATRICK
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
MSW
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1578517348
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/23/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 807
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LONDONDERRY
Provider Business Mailing Address State Name:
NH
Provider Business Mailing Address Postal Code:
03053-0807
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
603-508-1754
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
183 ROCKINGHAM ROAD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WINDHAM
Provider Business Practice Location Address State Name:
NH
Provider Business Practice Location Address Postal Code:
03087
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
603-434-9937
Provider Business Practice Location Address Fax Number:
603-434-0427
Provider Enumeration Date:
05/19/2006

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: 101Y00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 1041C0700X , with the licence number: 1333 , registered in the state of NH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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