Provider Demographics
NPI:1275848673
Name:COOKE, PATRICIA F (LPC)
Entity Type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:F
Last Name:COOKE
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 1:1331 SUNRISE AVE
Mailing Address - Street 2:
Mailing Address - City:POINT PLEASANT BORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08742-4278
Mailing Address - Country:US
Mailing Address - Phone:848-210-3964
Mailing Address - Fax:
Practice Address - Street 1:302 HAWTHORNE AVE
Practice Address - Street 2:
Practice Address - City:POINT PLEASANT BEACH
Practice Address - State:NJ
Practice Address - Zip Code:08742-2539
Practice Address - Country:US
Practice Address - Phone:848-210-3964
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-10
Last Update Date:2010-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00401800101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional