Provider Demographics
NPI:1114652112
Name:COOK, LAURA LEA
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:LEA
Last Name:COOK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2105 N GLEBE RD UNIT 2205
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22207-2235
Mailing Address - Country:US
Mailing Address - Phone:804-767-0435
Mailing Address - Fax:
Practice Address - Street 1:900 BLACK LIVES MATTER PLZ NW
Practice Address - Street 2:# 400
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20006
Practice Address - Country:US
Practice Address - Phone:202-909-2860
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-22
Last Update Date:2022-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health