Provider Demographics
NPI:1295840064
Name:CAULFIELD-COOK, ANN M (PHD LMSW)
Entity Type:Individual
Prefix:DR
First Name:ANN
Middle Name:M
Last Name:CAULFIELD-COOK
Suffix:
Gender:F
Credentials:PHD LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7608 ALLEN RD
Mailing Address - Street 2:
Mailing Address - City:ALLEN PARK
Mailing Address - State:MI
Mailing Address - Zip Code:48101-1926
Mailing Address - Country:US
Mailing Address - Phone:313-294-0195
Mailing Address - Fax:
Practice Address - Street 1:7608 ALLEN RD
Practice Address - Street 2:
Practice Address - City:ALLEN PARK
Practice Address - State:MI
Practice Address - Zip Code:48101-1926
Practice Address - Country:US
Practice Address - Phone:313-294-0195
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-20
Last Update Date:2013-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010184431041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI800892455OtherBCBS
MI4497833OtherAETNA
MI0M92190Medicare ID - Type Unspecified