Provider Demographics
NPI:1003994732
Name:COOK, DARREN GENE (MS)
Entity Type:Individual
Prefix:MR
First Name:DARREN
Middle Name:GENE
Last Name:COOK
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9512 CITY LIMIT RD
Mailing Address - Street 2:
Mailing Address - City:NEOSHO
Mailing Address - State:MO
Mailing Address - Zip Code:64850-7512
Mailing Address - Country:US
Mailing Address - Phone:417-472-7669
Mailing Address - Fax:
Practice Address - Street 1:LIFECARE FAMILY SERVICES
Practice Address - Street 2:112 S. MADISON
Practice Address - City:AURORA
Practice Address - State:MO
Practice Address - Zip Code:65605
Practice Address - Country:US
Practice Address - Phone:417-678-6233
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2006032931101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional