Provider Demographics
NPI:1003965773
Name:COOK, DAVID HUEY (LCSW)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:HUEY
Last Name:COOK
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:455 S 4TH ST STE 842
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40202-2576
Mailing Address - Country:US
Mailing Address - Phone:502-584-7216
Mailing Address - Fax:502-585-5373
Practice Address - Street 1:455 S 4TH ST STE 842
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202-2576
Practice Address - Country:US
Practice Address - Phone:502-584-7216
Practice Address - Fax:502-585-5373
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY-4081041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical