Provider Demographics
NPI:1114315223
Name:COOK, VINCENT (CASAC-T)
Entity Type:Individual
Prefix:MR
First Name:VINCENT
Middle Name:
Last Name:COOK
Suffix:
Gender:M
Credentials:CASAC-T
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:521 W 49TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-7560
Mailing Address - Country:US
Mailing Address - Phone:212-956-3429
Mailing Address - Fax:212-757-7681
Practice Address - Street 1:521 W 49TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-7560
Practice Address - Country:US
Practice Address - Phone:212-956-3429
Practice Address - Fax:212-757-7681
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-26
Last Update Date:2014-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)