Provider Demographics
NPI:1275149510
Name:COOK, MADELINE CHANDLER
Entity Type:Individual
Prefix:
First Name:MADELINE
Middle Name:CHANDLER
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 1:221 E MAIN ST STE 201
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01757-2826
Mailing Address - Country:US
Mailing Address - Phone:508-902-0080
Mailing Address - Fax:
Practice Address - Street 1:221 E MAIN ST STE 201
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:MA
Practice Address - Zip Code:01757-2826
Practice Address - Country:US
Practice Address - Phone:508-902-0080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-22
Last Update Date:2020-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor