Provider Demographics
NPI:1003512575
Name:COOK, RUTH HELEN (LMHC)
Entity Type:Individual
Prefix:
First Name:RUTH
Middle Name:HELEN
Last Name:COOK
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1594 MAJESTIC VIEW LN
Mailing Address - Street 2:
Mailing Address - City:FLEMING ISLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32003-3218
Mailing Address - Country:US
Mailing Address - Phone:727-365-6407
Mailing Address - Fax:
Practice Address - Street 1:1594 MAJESTIC VIEW LN
Practice Address - Street 2:
Practice Address - City:FLEMING ISLAND
Practice Address - State:FL
Practice Address - Zip Code:32003-3218
Practice Address - Country:US
Practice Address - Phone:727-365-6407
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-06
Last Update Date:2023-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH2944101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health