Provider Demographics
NPI:1225895626
Name:COOKE, SARAH (PHD)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:COOKE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9910 BLAIRBETH ST APT 2015
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28277-4250
Mailing Address - Country:US
Mailing Address - Phone:404-354-4627
Mailing Address - Fax:
Practice Address - Street 1:9910 BLAIRBETH ST APT 2015
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28277-4250
Practice Address - Country:US
Practice Address - Phone:404-354-4627
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-01
Last Update Date:2024-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPSYA00438103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist