Provider Demographics
NPI:1023194404
Name:COOKSY, JAMES WILLIAM (LICSW, LADC-I)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:WILLIAM
Last Name:COOKSY
Suffix:
Gender:M
Credentials:LICSW, LADC-I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:664 MAIN ST # A
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:MA
Mailing Address - Zip Code:01002-2439
Mailing Address - Country:US
Mailing Address - Phone:413-367-9741
Mailing Address - Fax:413-367-9741
Practice Address - Street 1:664 MAIN ST # A
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:MA
Practice Address - Zip Code:01002-2439
Practice Address - Country:US
Practice Address - Phone:413-367-9741
Practice Address - Fax:413-367-9741
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-28
Last Update Date:2007-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1028101YA0400X
MA1076731041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)