Provider Demographics
NPI:1114273968
Name:COOK, BENJAMIN CARTER (LPCA)
Entity Type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:CARTER
Last Name:COOK
Suffix:
Gender:M
Credentials:LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4230 HARDING PIKE STE 707
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37205-2031
Mailing Address - Country:US
Mailing Address - Phone:615-760-3990
Mailing Address - Fax:
Practice Address - Street 1:4230 HARDING PIKE STE 707
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37205-2031
Practice Address - Country:US
Practice Address - Phone:615-760-3990
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-31
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA9509101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health