Provider Demographics
NPI:1174273676
Name:COOK, SARAH SAMANTHA (LPC)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:SAMANTHA
Last Name:COOK
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1925 MILITARY ST S STE 1A
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:AL
Mailing Address - Zip Code:35570-6675
Mailing Address - Country:US
Mailing Address - Phone:205-443-2771
Mailing Address - Fax:
Practice Address - Street 1:1879 MILITARY ST S
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:AL
Practice Address - Zip Code:35570-6618
Practice Address - Country:US
Practice Address - Phone:205-921-3799
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-27
Last Update Date:2022-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL4497101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor