Provider Demographics
NPI:1114274644
Name:COOK, CHELSEY DANELL DEON (LADC/MH)
Entity Type:Individual
Prefix:MRS
First Name:CHELSEY
Middle Name:DANELL DEON
Last Name:COOK
Suffix:
Gender:F
Credentials:LADC/MH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1267
Mailing Address - Street 2:
Mailing Address - City:MUSKOGEE
Mailing Address - State:OK
Mailing Address - Zip Code:74402-1267
Mailing Address - Country:US
Mailing Address - Phone:918-682-7210
Mailing Address - Fax:918-682-0801
Practice Address - Street 1:2310 W BROADWAY ST
Practice Address - Street 2:
Practice Address - City:MUSKOGEE
Practice Address - State:OK
Practice Address - Zip Code:74401-2761
Practice Address - Country:US
Practice Address - Phone:918-380-0105
Practice Address - Fax:918-682-0801
Is Sole Proprietor?:No
Enumeration Date:2012-08-15
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1278101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)