Provider Demographics
NPI:1225340334
Name:RICHARD A COOK, PSYD, PC
Entity Type:Organization
Organization Name:RICHARD A COOK, PSYD, PC
Other - Org Name:COOK AND ASSOCIATES, PC
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:A
Authorized Official - Last Name:COOK
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:720-480-0349
Mailing Address - Street 1:3761 MALLARD ST
Mailing Address - Street 2:
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80126-2951
Mailing Address - Country:US
Mailing Address - Phone:720-480-0349
Mailing Address - Fax:303-741-0178
Practice Address - Street 1:3761 MALLARD ST
Practice Address - Street 2:
Practice Address - City:HIGHLANDS RANCH
Practice Address - State:CO
Practice Address - Zip Code:80126-2951
Practice Address - Country:US
Practice Address - Phone:720-480-0349
Practice Address - Fax:303-741-0178
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-06
Last Update Date:2010-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Single Specialty