Provider Demographics
NPI:1003922238
Name:COOK, JANET MARIE (LCSW-C)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:MARIE
Last Name:COOK
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:JANET
Other - Middle Name:
Other - Last Name:COOKSMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSSA
Mailing Address - Street 1:6501 N. CHARLES
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21204-4622
Mailing Address - Country:US
Mailing Address - Phone:410-938-3000
Mailing Address - Fax:
Practice Address - Street 1:6501 N. CHARLES
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21204-4622
Practice Address - Country:US
Practice Address - Phone:410-938-3000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-21
Last Update Date:2020-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD088451041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD275540800Medicaid
MDQI13JOtherBLUE CROSS BLUE SHIELD
MD2032074OtherCIGNA
MD170978000OtherAETNA
MD45824335OtherUNITED BEHAVIORAL HEALTH
MDQI13JOtherBLUE CROSS BLUE SHIELD