Provider Demographics
NPI:1093014953
Name:COOK, DANIEL (LCSW)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:
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 1:6812 N ORACLE RD
Mailing Address - Street 2:SUITE 124
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85704-4246
Mailing Address - Country:US
Mailing Address - Phone:520-336-1904
Mailing Address - Fax:
Practice Address - Street 1:6812 N ORACLE RD
Practice Address - Street 2:SUITE 124
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85704-4246
Practice Address - Country:US
Practice Address - Phone:520-336-1904
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-17
Last Update Date:2015-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ132311041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical